7 things to know about Major Depressive Disorder

Published on Monday, August 18, 2014 By Brad Wardell In Health & Medicine

For most of my adult life, I’ve suffered from what I euphemistically have described as melancholy. And like most people, I mistakenly considered it to be a “mood” as opposed to a serious physiological issue.  If I just did X, then I’d feel better. 

When the issue began to seriously affect my life, I readily accepted “advice” that included “appreciate what you have”, “look on the bright side”, “try to reduce stress from your life”, “don’t sweat the small stuff”, etc.

However, that type of advice is about as relevant as telling someone who suffers from severe migraines or epilepsy that they can “cure it” by changing their attitude about it. 

Understanding what depression actually is

Depression isn’t caused by external events.  Not the type I’m talking about anyway.  Obviously if enough bad things happen to you, you can be pretty down.  But major depressive disorder is an event that occurs in the brain where your serotonin levels drop very low.  Because the symptom of it is simply being in an extremely “down mood”. Unfortunately, people who suffer this are inclined to try to just push themselves through it which only serves to exacerbate it.

In video game terms, if one’s mental well-being can be described as mana, then everything we do each day results in actions that give or take a bit of that mana.  A bad event, like a death or a divorce will take away a lot of mana.  What makes MDD so serious is that it is a largely random event that essentially drops your mana to near zero. Suddenly, those day to day events that might not be that big of a deal become potentially life threatening (or sanity threatening).

For example, some people talk about seasonal depressive disorder.  I think a better way to think of it is that during certain times of the year, the conditions result in a steady trickle of mana. For most people, this might be no big deal or maybe a mild case of be somber.  On the other hand, if you are unlucky enough to have an MDD event around this time, that steady mana trickle can take you to a very very dark place.

There is no cure, there is only management

Being an engineer, I tend to focus on solutions. The idea I couldn’t “solve” depression seemed ludicrous.  Throughout my 20s I had a mantra: “The cure for the blues is achievement.”  I made an ambitious bucket list to work towards by the time I was 40.

And so 40 hit and I had done everything I had hoped to do by then. My family life was wonderful. I had beautiful, wonderful wife of nearly 20 years. 3 healthy, happy children. A beautiful home. More money than I could ever need. My book had been published by Random House and was at every book store I went to. Good physical health. Lots of friends. Good support network. Awesome job.

But accomplishment has nothing to do with depression. Depression doesn’t care. It’s a physical disorder.  It’s like suggesting that someone with diabetes just needs to get a big promotion at work and suddenly they’ll be cured.

Depression doesn’t make people any more sensitive

Having talked to other people who are in a similar situation, one of the most frustrating aspects is that many people think that those with depression are just more sensitive or that you need to be careful what you say around them.   Again: Depression is NOT caused by external factors. 

Just as depression can’t be cured by good events, it can’t be caused by bad events. It is not caused by some relative saying something rude or getting a mean email or some Facebook argument. 

The only time external factors become an issue is right after an MDD event has occurred that has brought your mana down to zero. Then it matters and the onus is on us to understand that and manage it.

How to manage it

Once I began thinking of depression as a physical issue, I was able to start effectively researching ways of managing it.  Here are the techniques I’ve learned over the past 3 years (I’m 43 now, it was 40 when I finally accepted that there was no magic accomplishment bullet).

None of these things will “cure” it. This is simply managing it so that you don’t go into “negative mana”:


  1. Mindfulness.  This means focusing on the moment. MDD events tend to cause people to dwell on everything that they imagine is bad. “I’m wasting my life”, “I’m not living up to expectations”, “Why am I still alive? What’s the point?”, “Nothing is worth doing anymore”.  You can’t talk yourself out of these things at that moment. Instead, you just need to distract yourself and focus on the moment.  For me, that means something as simple as taking a peek at the conservatory in the house at the lizards and watching them do what lizards do (answer: Not much).

    Mindfulness does NOT mean: Going for a walk, exercising, reading a book, etc.  It means find something around and focus on it for a bit. The simpler the better.
  2. Deconditioning. Where I work, I have a standing policy on “brain times”. We only care about what accomplish in the bigger scheme of things. We don’t care if you’re accomplishing it at 2:30pm on a Wednesday. If you need to take a brain break (defined as: working from home and at 2:30pm you instead read a book or do something in your garden because you’ve had “an event” recently then do it).  

    Deconditioning is, by far, the hardest thing to do because MDD comes with “I’m not living up to other people’s expectations” and therefore it makes it even harder to force yourself to just not do something that requires mana even if it’s in the middle of a work day. 

    I still struggle with this a lot and I own my own company. Yet, middle of the afternoon on a Tuesday I will force myself to read through a contract or some proposal or status report or some other thing that sucks the life out of me simply because it’s a work day in the afternoon. But I’m getting much better at simply rescheduling things so that I either spend that time doing something I enjoy (like writing code) or something unrelated (reading a book, playing with the dog, whatever).
  3. Drugs. There’s no way around this. SSRIs and related drugs are a life saver. Find ones that work for you and stick to them. Yea, it sucks to have to take something every day forever (until they do find a cure). But I already take a multivitamin.
  4. People. How you deal with people in this situation depends on if you’re an introvert or an extrovert. I’m an extrovert so I tend to enjoy being around people most of the time. I gain mana from socializing. But introverts lose mana from socializing.  So if you’ve had an event, deal with the people issue appropriately. You don’t go flying with a severe ear infection and you shouldn’t go present at a company meeting if you’re an introvert and you’ve recently had a MDD event (reschedule! Yes, DO IT).
  5. The right job. People say “Life is short” and proceed to live as if they’re immortal.  I had a financial advisor friend who joked that if I quit “messing around” I could be worth 9 to 10 figures instead of “merely” 8.  That gets back to the obvious: Having money has very little affect on MDD. MDD doesn’t care.  Epilepsy doesn’t go away if you have a lot of money either.   Instead, the right job means having a job that provides as many “mana generating” opportunities as possible with the fewest number of “mana absorbers” present.

    Where I work, we have an in-house fitness trainer, a nutritionist and (again, since hitting 40) it is forbidden to have anything resembling “crunch”. If someone is working a lot of hours, they’re asked if they’re doing it because they enjoy what they’re working on versus because they have some sense of obligation.  If it’s the latter, it’s discouraged and we can discuss the underlying issues.  A big part of this is employee retention.  Working with people you know and care about for many years is extremely helpful. 

    Having an environment where people feel there’s a lot of flexibility to learn and do new things over your career (tired of concept art? How about game design? Or how about cinematics? There’s time to learn).  At the same time, it also means having a lower stress environment where people are less likely to have anxiety or not get along as a result.
  6. Diet and Exercise.  These aren’t cures. But holy cow, making sure I am not eating crap can go a long way.  I love my mochas in the morning (they really help me) but I’ve moved away from fast food and the other garbage I used to ingest and just feel better. Poor diet is more like a drip drip drip to mana.  Similarly, it’s not so much that exercise will make you happy as much as inactivity is a constant drip drip drip to mana.
  7. Accepting what it is. Last but not least is accepting what MDD is. It’s a physical issue that has no simple cure. It is not some weakness in character. It is not a failure on your part to appreciate what you have.  It’s just as physical as epilepsy or diabetes or some other physical ailment.
    The only difference between MDD and any other ailment is that the symptoms of an MDD event come in the form misery that, if unmanaged, becomes utter despair that can be very dangerous.


I hope this helps others. It has taken me some years to get to this point.  Until recently, I’ve really not talked about this outside my family and a few very close friends.  But I’ve come to the conclusion that there are a lot of people out there facing these same challenges.

Most people who know me know me to be a pretty happy person. That’s because I am a happy person much of the time. Just like people can be very healthy until they have the flu, I am happy until I have an MDD event that requires me to have some care in how I manage it.