The Depression Cure

What Hacker News says

1. hmhrexJan 2026
   This is all in a book called The Depression Cure by Stephen S. Ilardi (https://bookshop.org/p/books/the-depression-cure-the-6-step-...)

   I read this years ago and it's fascinating. Looks like it's been updated for a second edition last year.

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2. pdfernhoutMay 2022
   Also related on problems with the current model, a 2015 book: "Deadly Psychiatry and Organised Denial" https://www.amazon.com/Deadly-Psychiatry-Organised-Denial-Go... "Deadly Psychiatry and Organized Denial explains in evidence-based detail why the way we currently use psychiatric drugs does far more harm than good. Professor, Doctor of Medical Science, Peter C. Gøtzsche documents that psychiatric drugs kill more than half a million people every year among those aged 65 and above in the United States and Europe. This makes psychiatric drugs the third leading cause of death, after heart disease and cancer. Gøtzsche explains that we could reduce our current usage of psychotropic drugs by 98% and at the same time improve patients' mental and physical health and survival. It can be difficult, however, to come off the drugs, as many people become dependent on them. As the withdrawal symptoms can be severe, long-lasting and even dangerous, slow tapering is usually necessary. In his book, Gøtzsche debunks the many myths that leading psychiatrists - very often on drug industry payroll - have created and nurtured over decades in order to conceal the fact that biological psychiatry has generally been a failure. Biological psychiatry sees drugs as the "solution" for virtually all problems, in marked contrast to the patients' views. Most patients don't respond to the drugs they receive but, unfortunately, the psychiatrists' frustrations over the lack of progress often lead to more diagnoses, more drugs and higher doses, harming the patients further."

   And from 2013 by the same author: "Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare" by Peter Gotzsche https://www.amazon.com/Deadly-Medicines-Organised-Crime-Heal... "Prescription drugs are the third leasing cause of death after heart disease and cancer. In his latest ground-breaking book, Peter C Gotzsche exposes the pharmaceutical industries and their charade of fraudulent behaviour, both in research and marketing where the morally repugnant disregard for human lives is the norm. He convincingly draws close comparisons with the tobacco conglomerates, revealing the extraordinary truth behind efforts to confuse and distract the public and their politicians. The book addresses, in evidence-based detail, an extraordinary system failure caused by widespread crime, corruption, bribery and impotent drug regulation in need of radical reforms. "The main reason we take so many drugs is that drug companies don't sell drugs, they sell lies about drugs. This is what makes drugs so different from anything else in life...Virtually everything we know about drugs is what the companies have chosen to tell us and our doctors...the reason patients trust their medicine is that they extrapolate the trust they have in their doctors into the medicines they prescribe. The patients don't realise that, although their doctors may know a lot about diseases and human physiology and psychology, they know very, very little about drugs that hasn't been carefully concocted and dressed up by the drug industry...If you don't think the system is out of control, please email me and explain why drugs are the third leading cause of death...If such a hugely lethal epidemic had been caused by a new bacterium or a virus, or even one-hundredth of it, we would have done everything we could to get it under control.""

   A 2009 book with some hopes for reform: "Why Our Health Matters: A Vision of Medicine That Can Transform Our Future Hardcover" by M.D. Andrew Weil (Author) https://www.amazon.com/Why-Our-Health-Matters-Transform/dp/1... "The second myth is that having the most elaborate and expensive medical technology in the world must translate into medical excellence. The reality is that medical technology has helped us in certain areas like the management of trauma and critical conditions. It has, however, served us very poorly in terms of creating cost-effective health care. In fact, one of the main reasons American health care is so expensive is that our interventions are based in expensive technology--including pharmaceutical drugs. There are many low-tech methods of intervening in disease that our doctors simply don't learn. Also, our entire health-care system is geared toward intervention in established disease, yet the vast majority of that disease is lifestyle related and therefore preventable. ... I think our efforts at prevention are feeble because we work from a model of prevention that is not very robust. The cornerstone of prevention should be lifestyle medicine. That means teaching people how to make better choices about how they eat, how they exercise, how they rest, how they neutralize stress. This is primarily something that needs to be done in terms of education, but the whole society has to pull in the same direction. The government and corporations both have to work to make the right lifestyle choices affordable and easy. You can't have the federal government telling people to eat more fruits and vegetables while at the same time making unhealthy foods cheap and healthy foods expensive through its patterns of crop subsidies. Also, a lot of our preventive efforts are very limited in that they have a lopsided preference for pharmaceutical drugs, like statins to prevent heart attacks or bone-building drugs to prevent osteoporosis. This is not the most cost-effective way to prevent disease. We need to think about prevention in new and better ways."

   An earlier book from 1982 on this sort of issue, including the disempowering psychology of our current medical system: "Medical Nemesis: The Expropriation of Health Paperback" by Ivan Illich https://www.amazon.com/Medical-Nemesis-Expropriation-Ivan-Il... ""The medical establishment has become a major threat to health." with this opening assertion, Ivan Illich - one of the most brilliant social critics of our time - launches a devastating analysis into "iatrogenesis" (doctor-made illness), examining what medicine really does, as opposed to the myth that has been built around it. "Medical Nemesis" poses some basic questions not only about the medical profession but about the direction of modern society and its dependence upon a maintenance system that is categorically robbing us of power, money, dignity - even life itself."

   From 1927: https://web.archive.org/web/20070222213243/https://soilandhe... "At this time in 1927, Dr. Shelton is already being harassed in his Hygienic practice by advocates of The Medical Mentality and by the police. In 1927, Dr. Shelton is jailed for the first time for "practicing medicine without a license" and is fined $100.00. This same year of 1927, a second arrest takes place, under similar circumstances and with charges of $300.00. His money is so tight this second time, he has to borrow to be released. Also, in 1927, the New York Evening Graphic lets Dr. Shelton go because he will not co-operate with their advertisement policies and insists on running an anti-smoking article. Still, during this time, Dr. Shelton's Hygienic practice grows; he is respected and admired for his efforts. The third arrest also occurs, all in New York, for "practicing medicine without a licence." The great irony is that Dr. Shelton would never "practice medicine"! Still, that is what the authorities call it when someone tells people how to live, how to sleep, how to eat, and how not to take medicines!"

   How it all went so wrong starting with the Flexner Report from 1910: "John D Rockefeller and the Flexner Report" https://www.youtube.com/watch?v=UhOgz5z0C-s

   Some quotes collected by me on the bigger picture of a broad breakdown in the scientific enterprise when profits and power are involved (especially in medicine): https://www.pdfernhout.net/to-james-randi-on-skepticism-abou...

   Given all that context, it is hard to imagine psychedelics being that much worse than current treatments for mental conditions -- even if some might be mostly placebos.

   The fact is, most mental ill health (not all, but most) can be inexpensively addressed by recognizing and then acting on this key fact: https://tlc.ku.edu/ "We were never designed for the sedentary, indoor, sleep-deprived, socially-isolated, fast-food-laden, frenetic pace of modern life. (Stephen Ilardi, PhD)"

   A related book by Ilardi: "The Depression Cure: The 6-Step Program to Beat Depression without Drugs" by Stephen S. Ilardi https://www.amazon.com/gp/product/B0097DHV94/ "In the past decade, depression rates have skyrocketed, and one in four Americans suffer from major depression at some point in their lives. Where have we gone wrong? Dr. Stephen Ilardi sheds light on our current predicament and reminds us that our bodies were never designed for the sleep-deprived, poorly nourished, frenzied pace of twenty-first century life. Inspired by the extraordinary resilience of aboriginal groups like the Kaluli of Papua New Guinea, Dr. Ilardi prescribes an easy-to-follow, clinically proven program that harks back to what our bodies were originally made for and what they continue to need with these six components: Brain Food; Don't Think, Do; Antidepressant Exercise; Let There Be Light; Get Connected; Habits of Healthy Sleep. The Depression Cure's holistic approach has been met with great success rates, helping even those who have failed to respond to traditional medications. For anyone looking to supplement their treatment, The Depression Cure offers hope and a practical path to wellness for anyone."

   Now, I know this all may sound like complete craziness to anyone who has bought 100% into the mainstream medical model -- but Virta Health is an example of one company growing quickly by using various non-drug interventions via telemedicine to get people off of diabetes medications: https://www.virtahealth.com/ "Our approach helps people lower blood sugar and lose weight, even while eliminating the need for medications, including insulin."

   This is presumably sort of the virtual version of what people like Dr. Joel Fuhrman and others like at True North Health Center have been doing in clinical practice and in retreats. https://www.drfuhrman.com/etlretreat https://www.healthpromoting.com/ https://web.archive.org/web/20150430050047/http://drfuhrman....

   This is potentially a huge growth area in the future for a great use of Y-Combinator-esque internet-based high-technology to support low-tech health interventions -- to help many people recover from chronic illnesses including diabetes, heart disease, and mental illness. Maybe not all -- but a lot. Essentially, the current Western Medical model is ripe for profitable-to-internet-based-company "disruption" or Peter Drucker's "Creative Destruction". Trillions of dollars that are being spent right now every year on "health" care (really "sick" care) in the USA are increasing in-play as they get redirected to new possibilities -- like Virta Health shows. Maybe psychedelics will play a part in this shift too (or maybe not). But change is possible -- and it seems to be gathering momentum.

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3. randycupertinoAug 2021
   I was actually suggested this book by someone on Hackernews and it was awesome for me- did more than meds and is pretty easy to follow: The Depression Cure by dr. Stephen Ilardi https://www.amazon.com/Depression-Cure-6-Step-Program-withou...

   I still go back and reread certain sections when I feel like I'm struggling.

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4. randycupertinoJun 2021
   The two books that helped me the most were The Depression Cure by Stephen Ilardi and Feeling Good by David Byrnes.
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5. pdfernhoutJul 2020
   Better options are available than prescription drugs in almost all cases. Almost all psychiatric medicines are essentially placebos -- often with harmful side effects including psychosis and where treating side-effects lead to a treadmill of medications. See: "Deadly Psychiatry and Organised Denial" by Peter C. Gøtzsche https://www.goodreads.com/book/show/26214735-deadly-psychiat... "Deadly Psychiatry and Organised Denial explains in evidence-based detail why the way we currently use psychiatric drugs does far more harm than good. Professor, Doctor of Medical Science, Peter C. Gøtzsche documents that psychiatric drugs kill more than half a million people every year among those aged 65 and above in the United States and Europe. This makes psychiatric drugs the third leading cause of death, after heart disease and cancer. Gøtzsche explains that we could reduce our current usage of psychotropic drugs by 98% and at the same time improve patients' mental and physical health and survival. It can be difficult, however, to come off the drugs, as many people become dependent on them. As the withdrawal symptoms can be severe, long-lasting and even dangerous, slow tapering is usually necessary. In his book, Gøtzsche debunks the many myths that leading psychiatrists - very often on drug industry payroll - have created and nurtured over decades in order to conceal the fact that biological psychiatry has generally been a failure. Biological psychiatry sees drugs as the "solution" for virtually all problems, in marked contrast to the patients' views. Most patients don't respond to the drugs they receive but, unfortunately, the psychiatrists' frustrations over the lack of progress often lead to more diagnoses, more drugs and higher doses, harming the patients further."

   For people facing psychological issues, see the resources I've collected in the "Health and Wellness" section of this reading list I have put together: https://github.com/pdfernhout/High-Performance-Organizations...

   If you can only look at one resource, read or watch something by Stephen Ilardi, PhD, author of "The Depression Cure: The 6-Step Program to Beat Depression without Drugs", whose advice is built around this quote of his: "We were never designed for the sedentary, indoor, sleep-deprived, socially-isolated, fast-food-laden, frenetic pace of modern life."

   Dr. Ilardi prescribes an easy-to-follow, clinically proven program that harks back to what our bodies were originally adapted for and what they continue to need with these six components:

       * Brain Food [supplement with Omega 3s; remember your brain is mostly fat]
       * Don't Think, Do [avoid excessive rumination by doing things]
       * Antidepressant Exercise [aerobic exercise is medicine]
       * Let There Be Light [get natural sunlight and supplement as needed with vitamin D3]
       * Get Connected [engage in face-to-face social activities regularly]
       * Habits of Healthy Sleep [get enough sleep by following basic guidelines]
   

   There are many other books as like the excellent "Why We Sleep" by Matthew Walker or many on nutrition (e.g. Fuhrman, Weil, Mackey, etc.) that examine aspects of this issue -- but what makes Ilardi's book so useful is bringing so many of these ideas together in a historical context. Ilardi says his advice is general and some people with specific traumas underlying their depression may need additional specific help (such as in "The Body Keeps The Score" book on recovery from trauma mentioned below).

   Other books that address specific aspects of depression and related issues of addiction, trauma, and perfectionism (and how they are at root deep cultural issues related to recent Western lifestyle changes) include:

       * "Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions" by Johann Hari. From the last chapter of the book: "You aren’t a machine with broken parts. You are an animal whose needs are not being met. You need to have a community. You need to have meaningful values, not the junk values you’ve been pumped full of all your life, telling you happiness comes through money and buying objects. You need to have meaningful work. You need the natural world. You need to feel you are respected. You need a secure future. You need connections to all these things. You need to release any shame you might feel for having been mistreated."
       * "Chasing the Scream: the First and Last Days of the War on Drugs" by Johann Hari
       * "The Globalization of Addiction: A Study in Poverty of the Spirit" by Bruce Alexander
       * "In the Realm of Hungry Ghosts: Close Encounters with Addiction" by Gabor Maté, MD
       * "The Story You Need to Tell: Writing to Heal from Trauma, Illness, or Loss" by Sandra Marinella
       * "Writing Hard Stories: Celebrated Memoirists Who Shaped Art from Trauma" by Melanie Brooks
       * "The Gifts of Imperfection: Let Go of Who You Think You're Supposed to Be and Embrace Who You Are" by Brené Brown
       * "Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead" by Brené Brown
   

   For people dealing with the special case of a specific trauma for themselves or a loved one, consider reading "The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma" by Bessel A. van der Kolk. As the blurb for that says, "Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Such experiences inevitably leave traces on minds, emotions, and even on biology. Sadly, trauma sufferers frequently pass on their stress to their partners and children. Renowned trauma expert Bessel van der Kolk has spent over three decades working with survivors. In The Body Keeps the Score, he transforms our understanding of traumatic stress, revealing how it literally rearranges the brain’s wiring -- specifically areas dedicated to pleasure, engagement, control, and trust. He shows how these areas can be reactivated through innovative treatments including neurofeedback, mindfulness techniques, play, yoga, and other therapies. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score offers proven alternatives to drugs and talk therapy -- and a way to reclaim lives."

   For those facing specific issues related to suicide for themselves or a loved one, a key book is: "Out of the Nightmare: Recovery from Depression and Suicidal Pain" by David Conroy. By reconceptualizing suicide as an involuntary action that occurs when total pain exceeds resources for coping with pain, David Conroy provides a morally neutral way for organizations and society to think about suicide prevention in a productive way. Rather than focus mainly on intervening in a crisis, organizations and societies can rethink their operations to reduce participant pain and to increase coping resources. This helps everyone -- not just those who have reached a threshold where pain is very close to coping resources. Aggregate pain includes physical pain, emotional pain, and social pain. Reducing pain in any area by even a small amount may bring a person below a threshold for suicide. Similarly there are many types of coping resources from interacting with a friend, to going to a funny movie, to receiving adequate health care, to interacting with a pet. There are also some short-term coping strategies like denial or drinking which may have long-term negative consequences that become new sources of pain when done to excess.

   As David Conroy says: "Suicide is not chosen; it happens when pain exceeds resources for coping with pain. That's all it's about. You are not a bad person, or crazy, or weak, or flawed, because you feel suicidal. It doesn't even mean that you really want to die - it only means that you have more pain than you can cope with right now. If I start piling weights on your shoulders, you will eventually collapse if I add enough weights... no matter how much you want to remain standing. Willpower has nothing to do with it. Of course you would cheer yourself up, if you could. Don't accept it if someone tells you, "That's not enough to be suicidal about." There are many kinds of pain that may lead to suicide. Whether or not the pain is bearable may differ from person to person. What might be bearable to someone else, may not be bearable to you. The point at which the pain becomes unbearable depends on what kinds of coping resources you have. Individuals vary greatly in their capacity to withstand pain. When pain exceeds pain-coping resources, suicidal feelings are the result. Suicide is neither wrong nor right; it is not a defect of character; it is morally neutral. It is simply an imbalance of pain versus coping resources. You can survive suicidal feelings if you do either of two things: (1) find a way to reduce your pain, or (2) find a way to increase your coping resources. Both are possible."

   (I write this in memory of my friend from Princeton, Robin Rochlin Cooperman, M.D. Psychiatry, 1963-2010. I can wish that she was still alive to talk with about all this newly emerging information about increasing wellness in a wide variety of ways beyond prescription pharmaceuticals. And also I write this in memory of other friends I have lost along the way...)

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6. valbacaMay 2020
   Hi there.

   So, I wrote this. I'm the original author. I'm amznymous (still proud of that username)

   It's wild to see this pop-up at the top of HackerNews 5 years later, but I'd be more than happy to answer any questions anyone has.

   I'm still at Amazon and have been on a couple of different teams since then, but this was definitely written at my lowest time at Amazon. I've had low times since then and high ones as well.

   I'm still an SDE II but on-track to become SDE III soon.

   I've interviewed elsewhere but was either unimpressed with the company (Facebook) or the company was not impressed enough with me and asked to try again later (Google). Facebook interviewers all looked absolutely exhausted and stressed and lifeless. They zoned out in the interview and just in general left a bad taste.

   One low point was when I found out (years after 2015) that the whole project that I had brutalized myself over was shutdown. Deleted. Scrapped. All of it.

   It was devastating and cathartic. I've become a bit more balanced, jaded, and care-free since then. Not totally, but just a bit.

   It's all just code. It's all just business and sometimes the business fails and everything you did doesn't matter anyway.

   I'm still glad I wrote the paste, if it helped one person out there. Based on reddit responses, I wasn't the only one going through this.

   =============================

   Since then things that help:

   0. Get that "Fuck You Money" I pinched pennies and followed Dave Ramsey's approach to get 100% debt free and thriving to ensure I never was locked in as I felt I was.

   1. Being absolute about my sleep schedule.

   2. Finding a good team. When you find a good team/manager, stick with it. Manager matters 10x more than the company

   3. Therapy. duh

   4. "Man's Search for Meaning" by Viktor E. Frankl

   5. "The Depression Cure" by Ilardi. This is NOT A SUBSTITUTE for therapy or medication. ONLY use it as a supplement . The tl;dr is take care of your body or your mind will pay the price.

   6. Soft skills: developing skills on how to provide estimates, pushing back on deadlines, and finding compromises between what business wants and what's feasible. It sounds obvious, but sometimes it really is just as easy as saying "that will take 2 weeks, what can be cut?"

   (Obvs, my opinions are my own and not my employer's)

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