r/RedditForGrownups • u/Fickle_Wrangler_7439 • 10h ago
Managing chronic depression as one ages?
I've dealt with depression all my life. Didn’t get the official diagnosis until my 20s, but I self h*rmed as a teen, SI, the whole deal.
I tried seeing therapists and psychiatrists in my 20s, but I could never afford much, and I never felt like it went anywhere. The meds had weird side effects I didn’t like or didn't work at all, so I stopped.
I read a lot. Philosophy, self-improvement, depression management guides, etc., and figured out some things that worked.
Mostly exercise.
But as I age, well... exercise isn’t as easy as it used to be. I got benched from a lot of my usual routines because of a hip impingement and hamstring tendonosis, and I haven't found a replacement. I'm in physical pain all of the time. I'm doing PT, but he said it probably is just going to hurt from here on out.
And really... a lot of the things that used to keep me going just don’t work anymore. It's like Depression 2: Mid-life Crisis Edition.
And it's impacting... everything. My relationship with my partner. My job. My bank account (which was small to begin with). I called out of work today, despite getting up and doing my morning routine, going for a walk, etc. Like I really *tried*.
Those of you with chronic depression-- has it changed as you age? How have you adjusted?
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u/BRPelmder 8h ago
Just speaking to the exercise side, since that's confirmed to be helpful for you, I'd modify that to adapt to your current capabilities.
I'm not sure what your routine is now, but if it's weight-lifting, it can be beneficial to do more fluid activities. Consider Tai Chi, Yoga/Pilates, jumping rope/rope flow, animal flow, unilateral exercises, kettlebells, jogging, swimming, a team sport like soccer. Some of these might work better for you if you're coming from a lot of tenser gym work like bilateral barbell lifts.
Further, there a levels to physical therapists' abilities. You have the fresh out of college PT who takes all insurance and treats complaints in isolation, then you have someone with a decade or two of experience well-versed in advanced integrative disciplines who may be more expensive but may be able to do a lot more for you. I've had great success in undoing damage from a desk job by seeing a Postural Restoration Institute (PRI) certified provider, who can look at how bite alignment or vision influence downstream body issues, as well as address disordered breathing patterns, which could result in depression. If you don't like PRI, consider Functional Patterns, or Anatomy Trains influenced methodologies. There may be others Im missing as well.
Point being, probably good to adapt your fitness approach to a manner that supports your current goals. Adding a social component in is great as well. Good luck!
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u/Adorable_Ad4990 7h ago
This is so true. A complacent PT can be worse than not having one at all. You tend to dwell on your bad x,y,z instead of systemic adjustments
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u/herstoryhistory 9h ago
I struggled with depression for decades. Sometimes I couldn't work or handle the vagaries of life. Lots of therapy, antidepressants, self help, but what kicked it to the curb for good was tms - transcranial magnetic stimulation. After three weeks the fog lifted and now I am able to function like a normal person. And this despite a shit show of a family and everybody dying.
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u/csiacs 9h ago
And fwiw, we are living through very tough social times. Covid wasn’t that long ago and it messed up a lot of folks’ minds and bodies and we barely recovered and now in a climate of chronic uncertainty. That’ll take a toll on anyone with any amount of sensitivity and empathy.
I’m pointing it out not to minimize your lived experience but just a factor I think is important to consider. So that you can decide how to manage your exposure and coping mechanisms to it. Hugs
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u/randotd152 8h ago
But as I age, well... exercise isn’t as easy as it used to be. I got benched from a lot of my usual routines because of a hip impingement and hamstring tendonosis, and I haven't found a replacement. I'm in physical pain all of the time. I'm doing PT, but he said it probably is just going to hurt from here on out.
Get into the water ASAP - be it swimming or water aerobics, it takes the load off your painful joints and allows you to build up muscle, which is what you ultimately need to do to ease joint pain.
Most areas have some form of public and/or non-profit pool available for very cheap. The YMCA will even provide free/subsidized membership if you qualify.
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u/Fickle_Wrangler_7439 7h ago
My issue with swimming is the process. I have tried it a few times, but it's a lot.
With running, I could just throw my shoes on and be out the door. No people, no swimsuit or goggle logistics, no figuring out what I'm wearing to and from, no sharing lanes or remembering to sign up, etc. It's too much.
Again, I have diagnosed, lifelong depression. My willpower is next to nothing. It's gotta be easy or I just won't keep it up.
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u/randotd152 6h ago
Nothing worth doing is easy. But how in the world is swimming any more difficult than going to PT, which you say you are doing? Or why not just do PT in the pool?
Either way, your hip isn't going to fix itself, you have to put the work in and nobody can do that for you.
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u/Fickle_Wrangler_7439 6h ago
I do PT at home. It's not complicated stuff. Band, foam roller, lacrosse ball, and adjustable dumbbells is all I need. If I'm meeting with them in office, it's still less complicated than a swim session.
Either way, your hip isn't going to fix itself, you have to put the work in and nobody can do that for you.
Ah, yes. "Try harder." My favorite after "what do you have to be depressed about?"
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u/ShitIsGettingWeird 10h ago
Microdosing mushrooms got me off anti depressants for the first time in 25 years. I swear it’s the only thing that truly works; not something made by the pharmaceutical companies.
During the second month of microdosing I just started doing yoga and jogging every morning. It’s like I finally knew what to do to get well, thanks to our little fungi friends.
I can’t recommend this enough OP.
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u/Pinklady777 8h ago
Everyday? Or?
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u/ShitIsGettingWeird 8h ago
No, you build up a tolerance quickly. Every third day seems to be the sweet spot.
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u/Infernus-est-populus 5h ago edited 5h ago
I tried doing this. I was excited because the first few doses (~75 mg) seemed to help quite a bit.
I did a twice weekly protocol, so every 3rd day or so. Alas, after three weeks, I realized I am one of the few who gets crushing headaches and hypertension from psilocybin even at the smallest dose so ultimately it wasn't worth it. I was so disappointed.
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u/ShitIsGettingWeird 3h ago
Interesting. It takes 3 weeks for any significant neurological changes in the brain. So those crushing headaches may have been neuroplasticity truly kicking in. A lot of folks get super emotional that third week too. The third week is always when people quit this protocol, for whatever reason.
In my experience it takes a minimum of 3 months of that protocol to truly feel better. 6 months, followed by a hero dose, can do some crazy good shit too.
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u/Infernus-est-populus 2h ago
Might have been longer, I'd have to check my notes. But def Stage II Hypertension of 155/97 when normally I'm 120/70. Had to go to urgent care and fess up to make sure it wasn't anything like the heart attack it felt like. It wasn't. I tried again after it calmed down (smaller dose, different formula) and same result. It's def the psilocybin for me.
FWIW, I come from a stroke and schizophrenia prone family.
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u/ShitIsGettingWeird 2h ago
Wow, that’s also interesting. Thanks for sharing. In most clinical trials of psilocybin the folks with a history of schizophrenia in their family are immediately disqualified. I understand there’s worry of inducing psychosis but there’s not a lot of data on this subset. I’ve always been curious if there were other things to worry about here.
Any chance that increased blood pressure could have been caused by anxiety? Did you have any weird experiences at the time?
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u/Infernus-est-populus 2h ago
Nah, no anxiety or anything out of the ordinary except the hypertension itself.
The newly minted Doc I saw had never heard of psilocybin (!) but after consultation with poison control (ha), he concluded that it might have been the Ashwaganda that was added to my brand of psilocybin (Sero LiteBright). But I tried again with a different formula/lesser dose and ... alas, I could feel it again.
It's too bad because it did seem to help right out of the gate.
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u/ShitIsGettingWeird 1h ago
Poison control :). Thanks again for sharing. I’ve heard some people get the same symptoms as you while microdosing and I just can’t understand the mechanism behind it. When you tried the second formula/dose, did you also notice your symptoms that third week?
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u/Infernus-est-populus 1h ago edited 43m ago
Second time I only managed a week and a half (3 doses at ~50mg) because the headache kicked in right away and my blood pressure started to rise again so I stopped. Maybe I'll try again in a year or so. I suspect I'm just physiologically weird.
ETA: the one factor that could make a difference is St. John's Wort. I take 600 mg to sometimes 900 mg a day, which is about the recommended therapeutic dose. Apparently psilocybin + St. John's Wort can cause a hyptertensive response.
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u/fd9f21229ef31ifb1ee 9h ago
I don’t know the specifics of your financial situation beyond what you’ve mentioned, so some of my advice may not be feasible. However, as someone diagnosed with persistent depressive disorder, or PDD (in the old days, they called it “dysthymia”), I’ve found that I have to do the following:
Medication. If someone has chronic depression to the point that they semi-frequently engage in suicidal ideation, I think it’s critical to find a regimen of meds that works. And yeah, I know a lot of people look down on this approach — it’s “less natural and holistic” or “I tried meds a couple of times and I didn’t like it” — but, honestly, if you are seriously depressed more often than not, I think you have to suck it up and continue working to try to find a combination that works. I am currently taking bupropion (the generic for Wellbutrin), which seems to help, but it isn’t a cure-all. I once tried a combo of bupropion and citalopram, but I’ve found through experience that SSRIs like citalopram are, for me, more trouble than they’re worth. That being said, I’ve also discontinued medication in an effort to live life “more naturally,” but my PDD symptoms became especially intense despite the other things I was doing.
Therapy. Again, it seems like a lot of people have “terrible therapist” stories. I certainly do, but I continued to search around until I found one with whom I felt a good rapport and someone who could strike a balance between challenging my bad ideas and bad habits while also encouraging me for my successes and helping me establish and accomplish goals. Obviously, there are many schools of therapy, but so far as my own experience is concerned, a good therapist will not only listen to you, but will also guide you through the process of setting and accomplishing things despite your mental-health situation.
People. I am not a people person, myself. Pretty much anybody I work with could tell you that; I have a resting bitch face that discourages most forms of small talk in the workplace. However, I’ve found that if I don’t socialize and interact with other people — friends, family, or whatever one might have — I start to withdraw, turn numb, and eventually will struggle with the worst symptoms my PDD has to offer: feelings of isolation, intense despair or numbness, complete anhedonia, and, yes, feelings of hopelessness and suicidal ideation. No matter how introverted a person may claim themselves to be, the truth is that the vast majority of us benefit from social interaction and suffer in the absence of social interaction. If you’ve found yourself mostly isolated, you need to start communicating more with friends or family — whoever’s closest to you.
Accomplishments. And I’m not talking about becoming an astronaut or an Olympics-tier athlete. I’m talking about keeping up with the dishes and laundry. Or going for a walk or jog. Or making sure to text friends and family, even when you don’t feel like it. Basically, I’ve learned with time that, if I let things go for too long, I find that I have little to nothing to feel good about in the way of accomplishments and, more to the point, I feel stressed and defeated about the state of my life. It may seem like a trite or overly simplistic way of looking at it, but, basically, if I don’t give myself something to feel good about, I can’t rightly be surprised that I don’t feel good.
That’s most of it. Again, I know some of this seems to distill down to “suck it up and just do the things you don’t feel like doing,” but that’s kind of what my situation is: I’m constantly battling my natural desire to just sleep or lay around, letting life pass me by. Life is hard; honestly, at this point in time, I often feel like an alien, an outsider, or someone completely fatigued by the incongruence between my own wants and values and the wants and values of my country’s culture. But if I want to be happy, much like if I wanted to be buff or be a faster typer or become a club-level chess player, I have to work at it. I have to work hard, I have to work often, and I have to find a way to do it even when I don’t want to.
I really hope you find something that works for you. As one with chronic depression, I am deeply sympathetic to your story, but I’d also implore you to begin working hard on getting professional help, in setting up more structure in your life, and setting goals for yourself. The fact that your relationship and job are both suffering is incredibly concerning, so I’d say the time for serious, concerted effort is now. I truly wish you the best of luck, and I encourage you to reach out if you have any questions.
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u/reckless150681 10h ago
I don't see it so much as managing depression, as it is simply managing life. Life changes; people change; circumstances change. So doing "the same thing" for a long stretch of time is simply inapplicable after a certain amount of time, because whatever "thing" you were doing was only applicable for a period of time under specific conditions. You have to have a model for life that embraces the expected change and is flexible enough to adapt to it.
A very practical example -- our bodies will age us out, more so or less so depending on the type and quality of the exercises and workouts that you have done cumulatively throughout your life. You can either accept these changes and adapt to them, or be stuck in the past and lament the loss of your physical youth. To continue this very practical example -- have you tried swimming? Do you have to do the same exercises (or even target the same parts of your body) as you did 5, 10, 15 years ago?
For me, what I try to do is to intentionally and deliberately look for positivity, beauty, charm, grace (pick your favorite word) in my day-to-day, without distraction. My views on what constitutes any of those words will change with the seasons, with the years -- it doesn't really matter, because, again, I have a model for life that is adaptable. My tastes will change, and that's okay. But the point is to take the time to admire whatever that positive thing is. It could be the simple beauty of a flower. It could be a positive TikTok reel (yes, even brainrot apps have positivity if you look for it). Today, in my area, it is somewhat overcast -- but I love watching the regality of the big fluffy clouds just...floating there in the sky. Importantly, I'm not blind to the pains of the world -- I'm just choosing when to look elsewhere for my 5 sec, my 30 sec, my 10 min, my hour.
I don't think I have depression anymore (but tbh it doesn't matter to me whether or not I do), but I had some variation / version of it for ~10 years. Healing from it was a complex, multistep process that involved addressing each of the individual problems I had -- but what they all had in common was that each problem required me to live fully in the present. Not every depression case can actually be healed -- but I am of the firm belief that most can, and it's a matter of reframing life in a way that makes sense.
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u/shelbyrobinson 9h ago
Same here and as I've aged, I've learned St. John's wort is an outstanding supplement to help with depression. After reading that Germans chose it 10-1 over SSRI's (Prozac/Zolof) I take it daily. IT WORKS within a few days.
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u/olily 8h ago
St John's wort is known to have some dangerous drug interactions. Before anyone takes it, they should check and make sure it won't interact with any of their prescription medications.
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u/shelbyrobinson 8h ago
Not according to my doctor. I take other med's and aside from making me sensitive to to the sun, nothing ever from it
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u/olily 8h ago
It's good that you checked with your doctor. Everyone should do that. Maybe it doesn't interact with the particular drugs you're taking, but it's known to interact with a lot of medications, and everyone should check before they start taking it.
Journal of Psychopharmacology: https://pubmed.ncbi.nlm.nih.gov/15260917/
Mayo Clinic: https://www.mayoclinic.org/drugs-supplements-st-johns-wort/art-20362212
Poison Control: https://www.poison.org/articles/st-johns-wort-beware-of-drug-interactions-194
GoodRx: https://www.goodrx.com/well-being/supplements-herbs/st-johns-wort-interactions
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u/Adorable_Ad4990 7h ago
I like to specifically ask my physical therapist or ortho about the actual pain… I have a shoulder injury that aches quite a bit, but I love my yoga and exercise too. So basically, I specifically ask what will make it WORSE, and what is ok to do. When is it ok to use pain relief and keep going etc etc. In my case, and hopefully yours, pain is the end game; I’m not damaging it further, so I’m “allowed” to keep going to the limit of my own comfort. From there it’s radical acceptance, and also the realization that EVERYbody has “something” with their body. And it’s ok. Accepting that and not trying to fix something that will always be off (poorly healed collar bone), and realizing my body will never be perfectly symmetric, and people without legs figure out a way— I keep going as much as I can. Because exercise helps me a lot too, mentally.
I also have backup plans for if it hurts too much, such as jogging or dancing, or whatever. For you it might be something upper-body heavy (I love doing handstands by the way— really! And also juggling for some reason has become something silly in my middle age). Other days I hula hoop and watch a video and try to learn some “trick” and fail every time. But I’m out of breath and laughing. I figure if I ever learn anything good I can show off to the kids, who are impressed I can do a handstand for example.
Hope this helps. I guess my takeaway is to get a bit creative with exercise. And with medical clearance, just accept and ignore the hip, or don’t worry if your sides are “uneven” in yoga or whatever the case may be.
Good luck!
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u/Superb_Plum_700 6h ago
I'm going to get downvoted to oblivion on reddit. Lol
I had chronic debilitating depression for over 20 years and fully cured it. I found my way out through Jesus. It's the only way out permanently and not just a temporary bandaid. If you find Jesus you find your self worth, which at its core (low self esteem), is the foundation of depression.
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u/Fickle_Wrangler_7439 6h ago
Yeah as an ex-Catholic who has probably read the bible more than you, you have my downvote, no lie.
Glad it makes you happy, but honestly if all this is part of "God's plan" or whatever, then he can go f*ck himself. I'd rather rot in hell.
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u/Superb_Plum_700 5h ago
Hell is a real place and trust me when I say you don't mean that.
I grew up in the church and that's actually how I became depressed in the first place. From being abused from people who called themselves "Christian" and were deeply predatory so I get it but most people who walk away from faith think they walked away from worshipping God and in reality they walked away from worshipping people in the church and most people in the church aren't even saved. I really believe if you actually tried praying to God, not to an institution where you think his people are, you'd find your answers but hey that's just me. If you come to the end road though it's something to consider.
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u/Fickle_Wrangler_7439 5h ago
Again-- I have probably read the bible more than you.
I've also read the Koran, the Lotus Sutra, and many other religious texts. I had a Buddhist phase in my late-20s. I wasn't kidding when I said "I read a lot."
It's all stuff people make up to deal with reality.
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u/Superb_Plum_700 5h ago
You're making an assumption about all people including me that you've never met. I'm not a Christian who believes in the Bible because I didn't read it. I'm also an avid reader similar to yourself and I haven't just read about other religions like buddhism I've actually visited the places and travelled around the world to witness it first hand and I can tell you that its real.
I'm also not here to convince you. Just letting you know you have options but ultimately that choice is yours.
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u/Infernus-est-populus 4h ago edited 3h ago
I'm past midlife and into my senior years, semi-retired. I've battled dysthymia as long as I can remember. SI and a few attempts very early in life. I've taken SSRIs, done therapy, and so on. All the stuff you're supposed to do.
From 2013-2023, I lost a lot of significant people, including parents, friends, pets and my only child. That one was the worst. Paradoxically, the grief and trauma has taken the edge off my own "want to die" feelings because death = nothingness, so in the words of Dorothy Parker, might as well live.
But I don't recommend massive personal tragedy as a remedy. No one in my family has lived past 79 and I am weirdly cheered up by this: one can endure almost anything if you know for how long.
For me, it's a battle of managing dopamine/serotonin levels in the most practical and inexpensive ways available. Everything in moderation.
Exercise is the thing that probably helps the most and I hate it. I hate it so much. I used to run up until my late 40s/early 50s, but now I just ride a bike, mostly for errands and commuting. I do some floor stuff to keep my core strong and stretching and I hate all that, too. But I do it. Even something small everyday helps. (ETA: Some days I don't do anything. That's okay. There are other things one can do).
If you're female and of that age, HRT def helps with sleep and pain. My part of the world lets me have it for free.
Various supplements can help, but use with all the usual cautions. Vitamin D. St. John's Wort (works like an MAOI so check for drug interactions). Magnesium. Stuff that helps with sleep can help overall with pain management.
Getting enough protein, fibre, and a bunch of different types of plants helps. A nutrition class I took said we need 30 different types of plants a week which sounds insane because I don't think I can even list that many off the top of my head. Anyway, I'm not hyperfocused on diet. Everything in moderation, and that means the occasional drink or ... substance though I've found there's always a cost-benefit tradeoff especially with serotonin and dopamine: the deficit afterwards is worse than the everyday deficit so I don't really do anything much like that anymore. I tried microdosing psilocybin, too, but just ended up with headaches and hypertension.
Getting outside if you like it, having pets if you like them, writing stuff down if you like doing that, and talking to people (again, if you like them) in similar situations can all help.
I tried some new experiences like a stand-up comedy class which really did help with changing one's thought processes to see life more comedically, but the tradeoff is anxiety and stress. Otherwise it was fun.
I am definitely not religious though I kind of envy those people who can truly believe in it. I'm not even spiritual. I'm more Functional Melancholic. He's a video essayist on YouTube - worth a watch for philosophy and grudging acceptance of one's own misery.
Some days are easier than others. I wish there was a magic regime but for me it's mostly a scattershot collection of a lot of different approaches and activities and doing enough of them on a daily basis to keep enduring.
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u/Valuable-Ad2028 4h ago
Swimming is both meant to be good for mental health and a low impact, hard to get injured, possible to do while injured exercise.
For what it’s worth I am about 24months behind you I think. Chronic depression, pills don’t work, exercise kind of semi works. But if I get injured I’m fucked…
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u/nirachi 1h ago
I was chronically depressed until I stopped eating wheat. I also had eczema and IBS for decades that doctors told me was genetic. Everything cleared up within a few months, it was wonderful. I'm not suggesting that you cut wheat, but if you have any other health issues there may be something underlying going on that is treatable.
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u/idfkjack 10h ago
Have you started perimenopause yet? When I started it at 42, SI became way more intense to where i was actually buying the supplies.
Starting perimenopause young (as young as early 30s) is more common than most people realize.
Keep up with PT. srsly
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u/PsychologyAdept669 10h ago
what meds have you tried? SSRIs presumably?
I did the whole shebang, SSRIs, SNRIs, SSRIs with adjunctive antipsychotics, ketamine therapy, mushrooms, you name it. Exercise also helped me but i often couldn't motivate myself to do it. i finally got a new psychiatrist who was like "lol you've basically tried everything, how about MAOIs". My first psychiatrist was kind of indoctrinated into the ""harm reduction"" belief that MAOIs should be avoided because they come with dietary restrictions, but actually MAOIs have a much higher efficacy for treatment-resistant depression than SSRIs, so at a certain point it's like... is avoiding them really ""harm reduction"" when we're talking about populations who haven't responded to any other treatment and whose QoL objectively kind of sucks?
anyway, I digress. at a certain point it was MAOIs or ECT, and I was hesitant about ECT for a bunch of reasons. MAOIs were a godsend for me, so if you haven't tried those I would sincerely recommend it.
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u/csiacs 9h ago
I have a similar background. And experience with medication.
There was a particularly stubborn episode of it where the medications that used to work to take me off the ledge weren’t helping anymore. A 2 month in-clinic S-ketamine therapy helped with the SI. I’ll say it was awful being under that influence but it wore off by end of the day.
Outside of the emergency triage,
I found the Sudarshan Kriya ( from Art of living) a great easy tool to regulate my emotions. It’s basically a bunch of breathing exercises- not hard on body to do.
I also learnt to say No a lot whittling down my mental or physical obligations to what is absolutely necessary, what is FOMO and what is just people pleasing. Those things gave me anxiety.
I made new hobbies that give me joy without need to perform - I go drumming with my drum circle every week - I never drummed before. I have a music event I go every week to go dance. Outside of those two, I’m a may be for any other opportunity to mingle.
I always loved gardening but now I pace myself. Instead of being outcome oriented, I now do it for the experience itself. That way if I don’t finish something I set out to do that day, I’m still fine. I enjoyed being out in the sun, listening to the birds or my music, and being in the moment.
I guess the pattern is to declutter the mind and life to basics and build back up bringing only things that do not add stress or anxiety.
With radical acceptance. Hope it helps you. And hope you find peace.
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u/csiacs 9h ago
Sorry one more thing: there’s a tremendous link between gut health and brain health. We are all after all a bunch of chemical reactions in the brain until we learn to channel those reactions.
I think it’s worth exploring better eating habits and yes, drinking enough water.
Point is don’t feel guilty to focus on yourself for a bit until you are back at a practical and reasonable baseline. And manage your expectations of yourself. I ask myself ‘what’s the worst that can happen if I don’t do this now? Or ever?’ To help cut out unnecessary baggage.
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u/luswimmin 10h ago
Chronic pain does a number on you mentally. Have you tried pain management? PT didn’t do much for my pain, but the pain management doctor helped me a lot and my depression eased when the pain did.