I'm chronically depressed, suffer from anxiety and stress, have high cholesterol (due to genetics) and I'm obese. Not to mention I have a family history of heart disease, on both sides.

I think that's more or less every single risk factor for heart disease. My current goal is to beat the odds and somehow die of something I'm not statically predisposed to, like cancer.

You still have sense of humor, which means life can bring good surprises. Please take care!

How you perceive a (depressed) person doesn't accurately describe how they perceive themselves. Humor can be part of the façade, the mask.

True.

A depressed person can easily put on a mask for several hours and appear completely normal to everyone they interact with. Some depressed people even manage to hold a façade up for months or years of working full time, though I imagine the stress in doing so is ove

But it doesn't really matter how other people perceive you. If you aren't happy with your self-perception, then you are going to have issues.

I don't mean to be that well-intentioned person to give unsolicited advice. But have you tried meditation (e.g. guided with a CD)? It reduces anxiety a lot, and depression is often linked to, or at least coexists, with anxiety. My life gets so much better once I meditate regularly.

Not sure if it helps, but this page lists a summary of protective factors that can help you (nutrition, exercise, stress management) : http://outcomereference.com/outcomes/27-Cardiovascular-Disea...

For me cognitive behavioral therapy with a very good psychotherapist was fundamental. I will just say what my therapist told me at the end of the first meeting "If you want it to work it will work, but if your problems were created in years of mental distress they won't go away any faster, it will be a long way. Be prepared."

Almost 3yr later I still have some very random depressive toughs in my head and sometime two or three very bad hours, but now I can recognize them for what they are and that part of my mind lost any real control on my daily life. I can focus freely on my work, I can finally sleep like a normal person and my biorhythm is finally decent after years of total randomness caused by almost self-imposed insomnia.

Consider investing in it, it was probably the best decision of my whole life.

Thanks for saying this. It sounds very similar to my situation. I have recently picked up the book "Feeling Good" by David Burns, MD and it has been helping. After years of therapy, I felt like I should be "fixed". Though things are better, that is not the case. It is constant and serious work with a focus on getting better. I do realize a big part of my problem is lifestyle. As you were saying, my self imposed insomnia, plus the stress and pressure I put on myself day to day. Glad to hear that you are doing better, and your post has encouraged me to seek out a therapist once more.

> For me cognitive behavioral therapy with a very good psychotherapist was fundamental.

How does one go about finding a good therapist? At $100+ per hour, I could see it costing potentially thousands to find someone that's just good, let alone very good.

In the past the wife and I tried going to a few different marriage counselors, it was not very encouraging.

In my state, marriage counselors have weaker licensure requirements than therapists, down to being licensable with a theology degree and a short practicum. Find out what licenses exist where you live and avoid anyone who hasn't completed the stricter license. Where I live the license to look for is Licensed Mental Health Counselor.

One possible place to check is your local university. I know the one by me has a good clinical psych program and they run a clinic that is open to the public. They charge on a sliding scale based on your income so it may be more affordable.

I can't afford it, and I live in a rural place that doesn't have a lot of the fancier kinds of doctors.

Long walks (especially with a bit of height) releases endorphins I believe.

Also forces a steady heart rhythm probably cancelling the disrupting effects of depression.

If I could walk I would go back to it immediately. That said depression also fucks up your will to do anything so you need to lose your "self" and bootstrap moving like a robot. Not very efficient method, but the only I know.

Wait, you can't walk ?

Figure of speech, I can't take long walks, swelling occurs for various reasons. I used to move a lot run, job, etc, I know well the effects of physical activity and right now I just cannot.

Exercise, sleep, meditation, diet, hobbies.

You may mean to be helpful, but think about what that can sound like like to the other person (I can't speak for the GP):

* You are so dumb that the problem ruining your life is one I can solve in five words.

* It's as easy as five words; obviously you are not trying.

It can sound worse to someone suffering from a (unfairly, ignorantly) stigmatized illness such as depression.

Also, consider that probably the other person likely has been dealing with this problem for awhile. The simplistic solution that comes to mind in 30 seconds probably is one they also considered in the first 30 seconds, and probably they are well beyond it at this point.

If only it was that easy

No one said it was easy. But, sometimes - if you're not too depressed - if you manage enough of these enough of the time (possibly with the help of a good friend nagging you) you can get enough of a feedback loop going to self-sustain and maintain a healthy living pattern long enough to sink in.

Sometimes sure. I agree, these healthy habits are prerequisites when you find yourself more depressed than usual.

But sometimes these healthy habits aren't going to be enough.

Not all depression is severe depression. Same with anxiety. In many cases people can manage it by themselves (e.g. without medication or extensive counseling).

I would like to add "don't drink any alcohol" to the list. I know that even a teatotaler can have a major depression but for me the decision to stop drinking any alcohol was THE key to make my depression much better.

It took me years to realize but drinking alcohol makes me sad and anxious for a a couple of days. The more I drink the worse the mood on the next day.

And how does that help with balancing real world problems like financial security, social expectation and self-actualisation? Your suggestions seem like distractions from reality, so perhaps you would also include hard drugs in your list?

And unsolicited advice.

Nootropics that also reduce anxiety?

I am experimenting with THC, CBD, and Lecithin, so far.

I started taking Lecithin about a week ago. On Saturday I took 40mg CBD. On Sunday (taking Lecithin as usual, but no CBD) I felt absolutely fantastic. In general, I have felt better for the last week. I'm also going to the gym about 4 times per week.

Completely not conclusive yet but I am continuing to investigate.

EDIT: Forgot Magnesium, for me this seems useful for anxiety.

In what form are you taking CBD. Oils? I am attempting to remove THC completely and focus more on CBD so I am curious.

What is CBD?

I don't know about nootropics, but often anxiety can be a factor of:

- low testosterone - high estrogen - high cortisol - low DHEA

At least as far as the physical effects go (paranoia, sweating, etc.)

Might be worth getting testosterone and sensitive e2 scanned. In particular if one is also obese (testosterone aromatises to estrogen in fat cells)

Nootropics are a scam. Most of the drugs come from China and don't have the proper QA shipment over shipment.