What Depression Is Like

post by Sable · 2024-08-27T17:43:22.549Z · LW · GW · 23 comments

This is a link post for https://affablyevil.substack.com/p/what-depression-is-like

Contents

  Sudoku
  Brain App
  Dimension 1
  Dimension 2
  Indirect Consequences
  Conclusion
None
23 comments

I was thinking to myself about the difficulties I have explaining depression to people, when I thought of a relatively good metaphor for it.

Bear with me.

Sudoku

For anyone unaware, Sudoku is a puzzle where one tries to fill in a 9x9 grid of numbers according to certain rules:

Sudoku - Wikipedia

 

Each row, column, and 3x3 square must have the numbers 1-9 in them, without repeating any numbers. Black numbers are given, red numbers start as blank squares and must be solved by the puzzler.

It’s a common form of brain teaser, much like a crossword puzzle or logic puzzle. Some Sudoku puzzles are difficult and some are easy; for our purposes we’ll think about ones that are relatively easy.

Brain App

Imagine, for a moment, that someone hacked your brain, and installed an app in it (don’t worry about the how). What this app does is force you to - whenever you want to do something - solve a mild Sudoku puzzle first. Not a hard one, it’s not difficult, just annoying. Want to get out of bed? Solve a Sudoku puzzle. Want to start work in the morning? Solve a Sudoku puzzle.

Want to get dressed, workout, eat, talk to someone, etc.?

First you’ve got to solve the puzzle.

At first it’s irritating, but you adapt. You figure out shortcuts for solving Sudoku puzzles. It’s brainpower you’re not expending on anything useful, but you get by.

This is the base case, the core of the metaphor.

Now we expand it.

There are two dimensions along which this nefarious app gets more annoying as time goes on:

  1. It decreases the granularity of the actions to which it applies. In other words, where before you had to solve a Sudoku puzzle to go to work, now you’ve got to solve a puzzle to get dressed, a puzzle to get in the car, a puzzle to drive, and a puzzle to actually get started working. Before all of those counted as a single action - ‘go to work’ - now they’re counted separately, as discrete steps, and each requires a puzzle.
  2. It increases the number of puzzles you have to solve to do anything. At first it’s just one Sudoku puzzle; eventually, it’s two, then three, and so on. Having to solve a single Sudoku puzzle whenever you want to do anything is annoying; having to solve five is downright irritating.

So what happens to you - what does your life look like - with this app running in your head?

Dimension 1

As the depression gets worse, the granularity of the actions requiring Sudoku solves gets smaller.

What does this look like?

At first you go through your normal morning routine, except that upon waking up, you need to solve the Sudoku puzzle to get started.

Then you have to do a Sudoku puzzle to get out of bed, another to make coffee, another to get dressed, another to shower, and so on.

Then you have to do a Sudoku puzzle to open your eyes, another to sit up, another to swing your legs around and another to actually stand up.

Finally, each individual muscle contraction comes with its own Sudoku puzzle. Want to sit up? That single action is composed of many pieces: your arms shift to support your weight, your stomach contracts to pull you up, your leg muscles tighten to keep your lower body in place. All of those now require their own puzzles.

Each puzzle, on its own, isn’t particularly difficult. But they do take some nonzero amount of effort, and when you add that required effort to every single thing you do, suddenly you find yourself doing a lot less. ‘Getting out of bed’ is now a complicated, multi-step operation that takes way more work than it used to.

Solving all these puzzles takes time, too, so you’re slower than you used to be at everything. Activities or jobs that you used to breeze through in seconds can stretch into minutes. Parts of your routine that never left you tired now leave you feeling like your brain has been lifting weights the whole time.

Dimension 2

Another way to think about how depression gets worse is that this app running in your head starts demanding you solve more and more Sudoku puzzles before doing anything.

At first you only have to solve a single puzzle to do your morning routine, get your work done, or go hand out with friends.

Then it’s two. Three. Five. Ten.

Fifty.

Just imagine what your life might be like - how you might feel - if you had to solve fifty mild Sudoku puzzles before doing anything.

Just the thought of having to solve them all is exhausting. And it’s not because they’re difficult, but rather because they’re boring. You don’t get anything out of solving them; they’re just a chore you have to complete before you’re allowed to get on with your life. Even if you enjoy doing such puzzles, having to do hundreds per day would quickly sap any pleasure you get. You’re not challenged or engaged, because the puzzle difficulty never changes. You’re not learning anything or growing.

You’re just going through the motions, over and over again.

How many activities could you manage per day, if the prerequisite for each of them was fifty Sudoku puzzles?

Indirect Consequences

Now envision the indirect consequences of this state of affairs. Because it’s not just that whatever you want to do now is blocked by the slog of puzzling, it’s every activity in the future.

Tomorrow and tomorrow and tomorrow you’ll experience the same boredom, the same lack of reward or challenge, the same difficulty getting anything accomplished, so…what’s the point in trying today?

Over time you’d grow apathetic, because you can only take so much disappointment before it burns you out.

You’d stay in bed all day doing nothing, because what’s the point of doing anything else? And eventually hunger or other bodily needs might drive you to do the fifty puzzles so you can eat or relieve yourself, but that’s about the extent to which you’d be willing to do anything.

You’d stop showering, stop going out, stop talking to your friends, stop…living.

Which…is pretty much what depression looks like.

Conclusion

It’s incredibly difficult to translate qualia between minds - to give others a genuine understanding of what one feels internally. This is true for emotions, for pain, for beauty, for taste…and it’s also true for mental illness.

I don’t know what it’s like to be bipolar or schizophrenic or psychotic, but I do have quite a bit of experience at this point with depression. I hope that this metaphor can help you express yourself better to others, if you’ve been depressed. If you’re not I hope it’ll help you empathize better with those who are.

It’s a difficult topic to talk about. Maybe this helps.

23 comments

Comments sorted by top scores.

comment by Gordon Seidoh Worley (gworley) · 2024-08-28T22:46:20.886Z · LW(p) · GW(p)

I was depressed for most of my 20s. I can't say it felt anything like having to solve a puzzle to do things. It instead felt like I didn't care, lacked motivation, etc. Things weren't hard to do, I just didn't want to do them or think doing them would be worthwhile because I expected bad stuff to happen as a result of doing things instead of good stuff.

Your model also contradicts most models I'm aware of that describe depression, which fit more with my own experience of a lack of motivation or care or drive to do things.

To me it sounds like you're describing something that is comorbid with depression for you. I don't have ADHD, but what you're describing pattern matches to how I hear people with ADHD describe the experience of trying to make themselves do things: like most activities are like a puzzle in that they require lots of S2-type thinking to make them happen.

Replies from: shankar-sivarajan, Archimedes, Sable
comment by Shankar Sivarajan (shankar-sivarajan) · 2024-08-29T01:52:57.019Z · LW(p) · GW(p)

The metaphor isn't meant for you. For a person who hasn't experienced depression, your description of "lacking motivation" or "not caring" is probably not helpful: I expect most people don't perceive their performing routine tasks as driven by any particular motivation, and so don't understand what a lack of motivation would be like. Something more concrete such a person can imagine, even if not hewing very closely to your experience, might be.

Also,

like having to solve a puzzle

I think you might be generalizing solving Sudoku in a way that wasn't intended. My understanding of the metaphor (which I agree with for the aspect of depression it seeks to describe) is that it's not meant to be tricky or particularly difficult in any way, just tedious. Perhaps you could substitute something like "multiplying two four-digit numbers" if you prefer. The idea is that if one had to do such a thing before one could get to any task, you can see how that'd lead one to cease to care about said tasks, and so one would stop "showering, going out, talking to friends" etc.

Replies from: gworley
comment by Gordon Seidoh Worley (gworley) · 2024-08-29T06:23:08.049Z · LW(p) · GW(p)

it's not meant to be tricky or particularly difficult in any way, just tedious.

Tedium still doesn't land for me as a description of what depression is like. I avoid doing all kinds of tedious things as a non-depressed person because I value my time. For example, I find cooking tedious, so I use money to buy my way out of having to spend a lot of time preparing meals, but I'm not depressed in general or about food specifically.

Perhaps depression makes things feel tedious that otherwise would not because of a lack of motivation to do them. For example, I like sweeping the floor, but sweeping the floor would feel tedious if I didn't get satisfaction from having clean floors. I probably wouldn't like sweeping the floor if I were depressed and didn't care about the floors being clean.

Maybe I'm splitting hairs here, but it seems to me worth making a clear distinction between what it feels like to be depressed and what are common symptoms of depression. The lack of care seems to me like a good approximation of what it feels like; tediousness or puzzle solving seems more like a symptom that shows up for many people, but it not in itself what is like to be depressed, even if it is a frequent type of experience one has while depressed.

Replies from: followthesilence
comment by followthesilence · 2024-08-29T14:40:47.423Z · LW(p) · GW(p)

The disagreement here seems to be around how literally one should interpret the metaphor. 

I agree depression could be more accurately described as "lack of caring" than "must do endless puzzles". However, the purpose of the post is to describe the depressive experience to people who cannot relate.

To that end, I like the sudoku metaphor. If you tell someone "depression means I just don't care and can't muster willpower to do things I should/need to do" a lot of people may -- consciously or not -- judge this as a voluntary condition where the solution approximates to "have you tried caring?" 

Sudokus help illustrate the (what feels like) involuntary roadblocks to otherwise simple life processes, the way these roadblocks ramify insidiously into more sub-components of life over time, and the level of fatigue, suffering, and defeat this inflicts.

comment by Archimedes · 2024-08-30T22:01:56.304Z · LW(p) · GW(p)

OP's model does not resonate with my experience either. For me, it's similar to constantly having the flu (or long COVID) in the sense that you persistently feel bad, and doing anything requires extra effort proportional to the severity of symptoms. The difference is that the symptoms mostly manifest in the brain rather than the body.

Replies from: jalex-stark-1
comment by Jalex Stark (jalex-stark-1) · 2024-09-22T16:07:33.152Z · LW(p) · GW(p)

doing anything requires extra effort proportional to the severity of symptoms

that's what the entire post is about?

Replies from: Archimedes
comment by Archimedes · 2024-09-27T02:37:16.202Z · LW(p) · GW(p)

Yes, but with a very different description of the subjective experience -- kind of like getting a sunburn on your back feels very different than most other types of back pain.

comment by Sable · 2024-09-05T19:44:01.566Z · LW(p) · GW(p)

The comments below do capture some of my thoughts. I also feel depression as a lack of motivation and general malaise and inability to care about things or feel pleasure.

But these are 

  1. difficult to explain to someone who's never felt, and
  2. subjective feelings, which don't always translate well through language.

The metaphor is meant to invite someone to think about what their life would be like if, in order to do anything, they had to slog their way through tedious effort for little to no reward. I claim that the result looks, externally, very much like depression - it would cause a lack of motivate, a general malaise, and a hoarding of energy and caring.

Sudoku was chosen as something that doesn't take much effort but gets mind-numbingly boring after enough time doing it; I emphasize that these aren't challenging puzzles, only ones that require a bare minimum of effort. Solving a jigsaw puzzle or multiplying numbers may also qualify.

comment by Adele Lopez (adele-lopez-1) · 2024-08-27T19:43:00.004Z · LW(p) · GW(p)

It decreases the granularity of the actions to which it applies. In other words, where before you had to solve a Sudoku puzzle to go to work, now you’ve got to solve a puzzle to get dressed, a puzzle to get in the car, a puzzle to drive, and a puzzle to actually get started working. Before all of those counted as a single action - ‘go to work’ - now they’re counted separately, as discrete steps, and each requires a puzzle.

This resonates strongly with my experience, though when I noticed this pattern I thought of it as part of my ADHD and not my depression. Maybe this is something like the mechanism via which ADHD causes depression.

Anyway, I've had mild success at improving productivity simply by trying to deliberately think of possible actions in coarser chunks. Plausibly this technique can be refined and improved–which I'd love to hear about if anyone figures this out!

Replies from: Fractalideation
comment by Fractalideation · 2024-08-28T01:19:59.911Z · LW(p) · GW(p)

This resonates strongly with my experience, though when I noticed this pattern I thought of it as part of my ADHD and not my depression. Maybe this is something like the mechanism via which ADHD causes depression.

Also resonates strongly with my own experience, in my case just replace "ADHD" with "ME/CFS".

I think OP description is good but quite generic i.e. it would probably resonate with most people who have a physical and/or mental health condition which is quite "taxing" in the sense that it significantly lowers the reward/effort ratio of every/most task.

As mentioned by Daniel Samuel comment, in the case of depression the "tax"/handicap would fall specifically on willpower (and/or enjoyment/pleasure/etc...). In the case of ADHD the tax/handicap would mostly fall on attention, in the case of ME/CFS it would mostly fall on energy, etc...

Replies from: Sable
comment by Sable · 2024-09-05T19:45:39.316Z · LW(p) · GW(p)

Interesting. I'm glad that this resonates, and like the idea that what I described was a generic experience, which can be caused by various issues in the brain.

comment by Shankar Sivarajan (shankar-sivarajan) · 2024-08-28T17:38:06.921Z · LW(p) · GW(p)

I endorse this as a metaphor for what psychomotor retardation feels like, and that is a significant and fairly characteristic feature of depression.

However, it completely misses what I'd consider the worse parts of the condition. I think this short film, Nuggets, normally a metaphor for addiction, captures that extremely well. Everything is … diminished. Colors turn to gray. Music becomes monotonous. Food tastes bland. And you remember dimly that things were better once, but can't quite remember what that felt like. And unlike with addiction, there is no bright light that brings you back even temporarily. 

I know they've been repurposed here to symbolize Death, but Rowling's dementors are a perfectly serviceable personification of the feeling.

As an aside, thanks to your excellent description of it, I now believe in "chronic fatigue syndrome" as a thing. I understand why noöne describes it as being like "depression without the really bad parts," but that would have helped me get it earlier.

comment by Daniel Samuel (daniel-samuel) · 2024-08-27T18:58:15.470Z · LW(p) · GW(p)

I like this concept. If you were to introduce the element of treatment, would you say it works according to two dimensions, or is there a better explanation/metaphor?

Personally, I also like to think about depression as a taxation on willpower with varying rates (low rate for mild depression, etc.).

Replies from: Sable
comment by Sable · 2024-09-05T19:49:28.310Z · LW(p) · GW(p)

I haven't thought much about how treatment fits in here. I've certainly felt both dimensions mentioned get better/reduced through treatment (having to solve less puzzles, having to solve puzzles for coarser/less granular actions).

Ultimately, 'curing' depression would be the equivalent of removing the app from your brain.

Replies from: ricardotwumasi
comment by ricardotkcl (ricardotwumasi) · 2024-09-05T21:15:52.585Z · LW(p) · GW(p)

I'm so sorry you're experiencing this.  It will improve. 

This is a really fascinating analogy. Building on the analogy with how different treatments (talking therapies, exercise, pharmacological interventions) influence or remove the app would be a lovely way to develop this.

Hang in there.

comment by Michael Cohn (michael-cohn) · 2024-09-09T05:24:03.901Z · LW(p) · GW(p)

Thanks for sharing this! It sounds to me like the folks in the comments saying this doesn't track for them are thinking about the intellectual challenge aspect of sudoku. If I think of it in terms of mental energy / annoyance / tedium, it definitely matches my experience of depression. The way tasks become more and more fine-grained is especially resonant, and painful to even read about. 

comment by cubefox · 2024-09-02T10:59:17.413Z · LW(p) · GW(p)

This is one way depression can manifest itself: it becomes harder to do anything. But another example of depression is being extremely unhappy and pessimistic all the time. This is somewhat independent of problems with motivation.

Replies from: Sable
comment by Sable · 2024-09-05T19:50:03.060Z · LW(p) · GW(p)

True. I just happen to have the 'very hard to do anything' kind, so that's what I describe.

Replies from: cubefox
comment by cubefox · 2024-09-05T20:57:44.431Z · LW(p) · GW(p)

Have you considered trying psilocybin? The effects of depression are so bad that I wouldn't worry much about it not being legally available.

Replies from: Sable
comment by Sable · 2024-09-07T10:28:48.865Z · LW(p) · GW(p)

I would love to try psilocybin, but can't because of where I work. I have tried Ketamine and am now trying TMS, which are the two FDA-approved 'nuclear options', and have been seeing some success with them.

comment by Jag Singh (jagveer-singh) · 2024-08-28T21:51:31.886Z · LW(p) · GW(p)

There is an interesting book called Brain Energy by Chris Palmer which may be relevant. It takes a stab at identifying the root physiological cause of mental health problems. His hypothesis is that many psychological and mental health issues are caused by problems in energy usage and metabolism in the brain. The increased resistance to even minor tasks you describe sounds like a brain trying to conserve energy.

I don't think I buy his ideas wholesale. I'm sure there are brains with perfectly healthy metabolic health that are nonetheless wired in ways that cause a particular mental health issue.

comment by bvbvbvbvbvbvbvbvbvbvbv · 2024-09-05T15:16:35.122Z · LW(p) · GW(p)

Very interesting of you to think of it that way. It turns out that it's very in line with recent results from computation psychiatry. Basically in depression we can study and distinguish how much the lack of activity is due to "lack of ressource to act" vs "increased cost of action". Both look clinically about the same but underlying biochemical pathways differ, so it's a (IMHO) promising approach to shorten the times it takes for a doctor to find the appropriate treatment for a given patient.

If that's something you already know I'm sorry, I'm short on time and wanted this to be out :)

Replies from: Sable
comment by Sable · 2024-09-05T19:50:56.571Z · LW(p) · GW(p)

That's really interesting! I'm no expert in neurology, so thanks for the heads up!