Many LessWrong users are depressed. On the most recent survey, 18.2% of respondents had been formally diagnosed with depression, and a further 25.5% self-diagnosed with depression. That adds up to nearly half of the LessWrong userbase.
One common treatment for depression is talk therapy. Jonah Sinick writes:
Talk therapy has been shown to reduce depression on average. However:
- Professional therapists are expensive, often charging on order of $120/week if one's insurance doesn't cover them.
- Anecdotally, highly intelligent people find therapy less useful than the average person does, perhaps because there's a gap in intelligence between them and most therapists that makes it difficult for the therapist to understand them.
House of Cards by Robyn Dawes argues that there's no evidence that licensed therapists are better at performing therapy than minimally trained laypeople. The evidence therein raises the possibility that one can derive the benefits of seeing a therapist from talking to a friend.
This requires that one has a friend who:
- is willing to talk with you about your emotions on a regular basis
- you trust to the point of feeling comfortable sharing your emotions
Some reasons to think that talking with a friend may not carry the full benefits of talking with a therapist are
- Conflict of interest — Your friend may be biased for reasons having to do with your pre-existing relationship – for example, he or she might be unwilling to ask certain questions or offer certain feedback out of concern of offending you and damaging your friendship.
- Risk of damaged relationship dynamics — There's a possibility of your friend feeling burdened by a sense of obligation to help you, creating feelings of resentment, and/or of you feeling guilty.
- Risk of breach of confidentiality — Since you and your friend know people in common, there's a possibility that your friend will reveal things that you say to others who you know, that you might not want to be known. In contrast, a therapist generally won't know people in common with you, and is professionally obliged to keep what you say confidential.
Depending on the friend and on the nature of help that you need, these factors may be non-issues, but they're worth considering when deciding between seeing a therapist and talking with a friend.
One idea for solving the problems with talking to a friend is to find someone intellectually similar to you who you don't know--say, someone else who reads LessWrong.
This is a thread for doing that. Please post if you're either interested in using someone as a sounding board or interested in making money being a sounding board using Skype or Google Hangouts. If you want to make money talking to people, I suggest writing out a little resume describing why you might be a nice person to talk to, the time zone you're in, your age (age-matching recommended by Kate), and the hourly rate you wish to charge. You could include your location for improved internet call quality. You might also include contact info to decrease trivial inconveniences for readers who haven't registered a LW account. (I have a feeling that trivial inconveniences are a bigger issue for depressed people.) To help prevent email address harvesting, the convention for this thread is if you write "Contact me at [somename]", that's assumed to mean "my email is [somename]@gmail.com".
Please don't be shy about posting if this sounds like a good fit for you. Let's give people as many options as possible.
I guess another option for folks on a budget is making reciprocal conversation arrangements with another depressed person. So feel free to try & arrange that in this thread as well. I think paying someone is ideal though; listening to depressed people can sometimes be depressing.
BlahTherapy is an interesting site that sets you up with strangers on the internet to talk about your problems with. However, these strangers likely won't have the advantages of high intelligence or shared conceptual vocabulary LessWrong users have. Fortunately we can roll our own version of BlahTherapy by designating "lesswrong-talk-to-someone" as the Schelling interest on Omegle.com. (You can also just use lesswrong as an interest, there are sometimes people on. Or enter random intellectual interests to find smart people to talk to.)
I haven't had very good results using sites like BlahTherapy. I think it's because I only sometimes find someone good, and when they don't work, I end up more depressed than I started. Reaching out in hopes of finding a friend and failing is a depressing experience. So I recommend trying to create a stable relationship with regularly scheduled conversations. I included BlahTherapy and Omegle because they might work well for some people and I didn't want to extrapolate strongly from n=1.
LessWrong user ShannonFriedman seems to work as a life coach judging by the link in her profile. I recommend her posts How to Deal with Depression - The Meta Layers and The Anti-Placebo Effect.
There's also the How to Get Therapy series from LW-sphere blog Gruntled & Hinged. It's primarily directed at people looking for licensed therapists, but may also have useful tips if you're just looking for someone to talk to. The biggest tip I noticed was to schedule a relaxing activity & time to decompress after your conversation.
The book Focusing is supposed to explain the techniques that successful therapy patients use that separate them from unsuccessful therapy patients. Anna Salamon recommends the audiobook version.
There's also: Methods for Treating Depression, Things That Sometimes Help If You Have Depression.
I apologize for including so many ideas, but I figured it was better to suggest a variety of approaches so the community can collectively identify the most effective solutions for the rationalist depression epidemic. In general, when I'm depressed, I notice myself starting and stopping activities in a very haphazard way, repeatedly telling myself that the activity I'm doing isn't the one I "should" be doing. I've found it pretty useful to choose one activity arbitrarily and persist in it for a while. This is often sufficient to bootstrap myself out of a depressed state. I'd recommend doing the same here: choose an option and put a nontrivial amount of effort into exploring it before discarding it. Create a todo list and bulldoze your way down it.
Good luck. I'm rooting for you!
Legal note: Talking to unlicensed people over the internet is not a substitute for professional help. If you are depressed you should visit a licensed therapist.
There's definitely space for this kind of conversation on the Slack Chat (http://lesswrong.com/r/discussion/lw/mpq/lesswrong_real_time_chat/). If there was enough demand, then we could create a specific channel for it. I'm sure Elliot would be willing to provide people with a second anonymous account if they desired that.
easily done. yes.
I am available. PM me any time, my timezone is GMT+10.
I realise there is a barrier to contacting me (having to make an account), but I have been contacted by over 100 people who were looking for access to the slack chat.
I don't mind making it slightly hard for people to reach me; you have to be able to recognise a failing (depression) and be willing to leave your current state before I can help.
I will be waiting.
I'd be happy to talk with anyone.
Time zone: EST UTC-05:00
Email: email@example.com (or PM me)
I'm very willing to make this commitment, and I think it's a great idea.
Doesn't it also happen in the opposite direction? The depressed person suddenly saying "I don't want to talk about it anymore" exactly at the moment you feel there might be a solution for them? Maybe the commitment for N sessions should be for both sides.
I don't think that it's helpful when a depressed person feels like they are forced by a commitment to have the conversation.
I'm available; timezone UTC+08:00 (China(I speak English and Spanish, though)). PM me, or contact me at firstname.lastname@example.org.
Love the push for instrumental rationality. Just the kind of simple organization that could get the ball rolling
By the way, did you mean to write that therapy can cost $120/week? Depending on how many hours in a week that buys, that could be really cheap.
For coaches: McKenna & Davis 2009 say a coach should "draw out and deepen the client’s own theory of his situation and how he can deal with it most effectively. No matter how brilliant you are, the client will ultimately take or not take action based on his own theory. It’s more important that she be right than that you be right." So, it's better to be a great listener than a great problem solver. See also.
I've always believed some version of that, but my thoughts have been confused. Reading that makes a ton of sense and has definitely deepened my level of understanding that point - thanks!
I don't think that's an accurate description.
The book describes an ability that most successful patients have. Then it describes a technique for building that ability. It doesn't claim that the technique is the only way to build that ability.
I have a fair amount of coach training in different methodologies and happy to practice my coaching skills with people who seek help. I'm happy to do it for free for the time being.
Time Zone: CET UTC+01:00
Email (rot13): email@example.com
The best medium would likely be Skype, or something with better encryption should you want to discuss issues that you don't want to have within NSA reach. If you don't want me to take any notes that go into Evernote because of survailance concerns, express that desire explictely.
Is the money a requirement? Ie. could you volunteer as a free resource, or would that mess the market dynamics up? What is the thinking?
I wasn't sure if people would be willing to volunteer for free or not. You're more than welcome to.
The nice thing about money is that it helps the supply of listener hours expand to meet the demand, if they aren't well matched. I imagine if I had framed it as a volunteer thing, people would not be comfortable asking for money, even if being able to ask for money would have the beneficial effect of expanding supply to meet demand. So I think volunteering is fine but asking for money should be fine too.
I guess maybe I thought spending an hour a week talking to someone for an indefinite number of weeks felt like a lot to ask of a casual volunteer, but that volume of conversation also seemed like it might be pretty helpful for some people? Money helps avoid the awkward question of the point at which a volunteer's commitment ends. If the nature of a person's depression is such that they are very concerned about being burdensome, this could be important.
Edit: I heard that the biggest downside of casual listening is that the casual listener will sometimes just say "I don't feel like doing this any more", which can be tough on the depressed person. So maybe the norm should be that if you are taking money in order to help someone, you should stay committed to helping them.
Agreed about the commitment.
I'm a bit worried that with the option of free, a lot of people will feel too guilty to ask for money, and that the supply would go down (ie. some people who otherwise would only do it for money wouldn't do it for money now that the free option is available). But on the other hand, the people who wouldn't feel comfortable doing it for money but would feel comfortable doing it for free would push the supply up. My impression is that overall, the result will be a higher supply, and that the free option is worth it.
LW has members from many countries. Are we sure it's legal for people without a medical license to charge money for providing mental help in all of those countries?
Isn't the usual trick is to put a very nice disclaimer saying that "this does not substitute professional advice, and if you are depressed you should visit a therapist" or something contradictory that removes all your belief in how much help that'll give you.
I was careful in my post to use language indicating that this is not therapy, just having someone to talk to (e.g. the way a life coach might talk to you). If you think I could have made that more clear, feel free to send me PMs with suggestions (ideally based on legal research).
I'm in Eastern Standard Time in North America and have done a ton of volunteer hours at www.7cupsoftea.com, a peer counselling service. I'm very confident in my ability to be a good active listener to other intelligent people as a result of my training there, as well as having access to a lot of techniques from DBT and CBT. Not sure about cost, but for now I assume I have the ability to do it for free. Message me here on LW or at j.runds at gmail
How about something like #lw-help ?
There is already a #lw-support on freenode.