Despite everything, depression lingers
Honesty is the best policy: this is hard.
It’s hard to summarize the last few months without sounding boastful. In a word, my life has been awesome. I’ve learned depression doesn’t care about that.
In June, I wrote my first Semantic Kernel (SK) app — and I did it for work. I was getting paid to use AI. I didn’t know it then, but that was the beginning of me starting my dream job. It was a simple app, and it didn’t take full advantage of all the features available, of course, but it worked and my coworkers were impressed. I had gone from writing about AI to writing AI and it felt great!
In July, I spent 3 weeks in the Midwest, including a week-long vacation with college friends at a cabin on a lake. Idyllic. Sure, my PTSD kicked in for the first day or two but once I got over that it was chilling, reading, tanning, swimming, laughing, storytelling, and gaming with some awesome friends. It’s hard to imagine a better vacation. Beyond that, it was good to see my family again — everyone flew in for a day just for the halibut. (That was a pun, no fish was served, but it was a darn good time.)
In August, my AI career started in earnest. Microsoft’s pivot to AI didn’t miss my team, and we added some projects whose motivations were “show what you can do with OpenAI models.” My boss’s boss has made sure I’m heavily involved in this process — turns out he’s been reading my writing and thinks I’m the right guy for the job. Never has an investment paid off so well. And we’ve done some amazing work. I’ve written a ton more about AI, learned even more, and honestly I designed a good portion of the AI parts of our new app. I designed a copilot. Feels kinda weird to say, but it’s true! I guided the development with an open mind towards either LangChain or Semantic Kernel, we settled on SK, and I introduced the concept of planners and baked vs fried plans, which is now the core of the copilot. I’m a big part of discussions around how to design plugins, and these discussions include my boss’s boss’s boss, and probably his boss soon too. So my work became my dream job and my bosses have taken notice. Their feedback has been very positive and our team has done a great job working like a startup. It’s not all shiny coding — I spent 3 days just building a bookmarks feature — but we’re doing what needs to be done to provide an awesome user experience, and I’m proud of what we’ve accomplished. Honestly, I’m honored to be a part of such a passionate team.
So why did I struggle to do anything yesterday, opting to sleep instead of code, play video games, go outside, or talk with friends? Why did I wonder if any of that means anything?
Despite everything, depression lingers — no escape.
I’ve had depression since I was 11 years old. It was my eleventh birthday, actually, when I started behaving radically differently than your average pre-teen. We don’t need to get into the nitty-gritty here, that’s what my 5-minute autobio is for. The point is that it’s been a while, I’ve seen many doctors for it, and I’ve learned a lot about it.
Most recently, I learned that folks who have a depressive episode are about — I’m trying my best to recall the numbers, please don’t take this as medical advice — 40% likely to have a second one. If you’ve had 2, there’s a 70% chance you’ll have a third. And at 3, there’s a 90% chance of a fourth. The 90% number I remember vividly. I wrote this down when my psychiatrist told me, and I asked him to confirm a few times over the next month or so. 90%. Next to this, I wrote down the depressive episodes I could remember: age 11, 14, 15, 19, 20… hmm. I think I got to 6 or 7 total. After 7 depressive episodes, what do you think the odds are that there’ll be an eighth?
I didn’t argue with my psychiatrist when he recommended I stay on anti-depressants for the rest of my life.
Another thing I’ve learned about depressive episodes is that they take about 2 months to actually qualify as depression and not just a bad week/month. (Again, the numbers here are rough and I’m not in the mood to look them up, please remember I’m a coder not a doctor!) So I’m well aware that this week-long funk could dissipate at any moment and not get added to my oh-so-fun list of Times that Mark was Officially Sad. (Sorry not sorry, I do need to joke about this a bit — it’s hard to confront head-on.)
The fact of the matter is that I’ve been feeling quite apathetic lately, and these feelings seem to occur independent of how objectively awesome my life is.
The stigma is real. But the disease is real too.
There is a lot of shame around depression. People think there’s something wrong with them. Not their bodies, but their selves. Getting cancer sucks, but it doesn’t make you a bad person. In some circles, depressed people are looked down upon. The stigma is real. But the disease is real too.
The drugs I take are SSRIs — selective serotonin re-uptake inhibitors. I took a few classes on neurobio in college so I’m not just making stuff up here. Your brain runs on a few different chemicals — neurotransmitters, I call them NTs — bouncing around between your neurons. The bouncing is structured: One neuron bundles a batch of NTs and then releases it near the receptors of another neuron. Most NTs are absorbed by the recipient, but some bounce away because nobody’s perfect. The bouncy NTs often get re-absorbed by the donor, and when this happens they don’t really work. Sometimes, the bouncy NTs are double bouncy: they bounce off the recipient, then off the donor, and then they’re absorbed back by the recipient, so they do get to work! The brain is weird, isn’t it?
Anyway, these NTs do a lot of different things. They include oxytocin, “the cuddle chemical,” which makes us seek affection and connection. There’s also adrenalin, everyone’s favorite “AHH GOTTA DO SOMETHING” drug, great for running away from crocodiles. There’s also gamers’ favorite chemical: dopamine. But really there are over a hundred NTs, and we’re still finding more.
What am I getting at? Well, let’s break down what a selective serotonin re-uptake inhibitor does: It inhibits re-uptake of serotonin, selectively. So the bouncy serotonin doesn’t go back to the donor as much. Since it doesn’t go back to the donor, it’s more likely to bounce back to the recipient and get used! What does serotonin do? Did you say “Its biological function is complex and multifaceted, modulating mood, cognition, reward, learning, memory, and numerous physiological processes such as vomiting and vasoconstriction”? If so, you were probably quoting Wikipedia! But man, can you imagine how rough life would be without enough serotonin — bad moods, low cognition, apathy, difficulty learning and remembering?
That kinda sounds like a depressed person to me, a depressed person.
I sure am glad there’s an FDA-approved way to increase the effective amount of serotonin working in a depressed person’s brain! I’ll clarify quickly that this is not the only cause of depression, and again we don’t understand everything here. But increasing serotonin often helps alleviate symptoms, and it sure is working for me. Unfortunately, I know people who don’t respond to SSRIs well, but there are many other treatments for depression. If this resonates with you, please consult a doctor — they’re the experts!
Here’s the point: just like cancer doesn’t reflect on a person’s goodness because their cells are mindlessly reproducing endlessly, depression doesn’t reflect on a person’s goodness because their serotonin receptors are mindlessly weaker inexplicably. Nobody chooses to be sick.
I’ve been reading a lot about AI, and folks are really into Nick Bostrom’s Orthogonality Thesis. Basically, any level of intelligence can be paired with any goal: Your AI might be smart and good, smart and evil, dumb and evil, dumb and good, or anywhere in between. Lovely. The thesis is named as such because it claims that levels of intelligence are orthogonal to goodness: changing one doesn’t imply a change in the other.
Orthogonal.
It’s a nice word.
I feel like “how well your life is going” and “how well your serotonin receptors are working” are pretty orthogonal. I really wish I could present this in a more poetic way, but life isn’t really all that poetic all the time, so here we are.
My life is going well. My serotonin receptors aren’t working so well. Before you get on my case for not taking care of myself: I’m eating well, exercising often, going outside daily, reading books, staying away from screens in the late evenings, seeing friends both in-person and virtually, and I’ve even pet a good amount of dogs recently. I’m doing my best, I promise.
These dang serotonin receptors just don’t seem to be working this week.
As someone who’s dealt with more depressive episodes than I can remember, I’m well aware that life is not all sunshine and roses. Even when the sun is shining, the roses may have wilted. Or it could just be cold out. There are a lot of days that could be worse — at least it’s not raining — but could also be better. I’m willing to bet that covers at least 99.84% of all days experienced by mankind. I have a degree in math so you can trust me.
Every morning, I wake up to a pretty good day. It could be better — my serotonin receptors could be stronger — but it could sure be a lot worse. I’m extraordinarily blessed and fortunate to live the incredible life I’m living. Sometimes I feel it’s a waste to go to a depressed guy, but I shrug that off because I’d rather have this life than some random one.
So I’m moving on. What’s cold today may be nice and warm tomorrow, I’m not worried about that too much. Roses wilt. After that, if properly cared for, they just might bloom.
