Ask HN: Has anyone here turned around their life in their 40s?

You need to see a therapist. Your problem is largely on your outlook on where you are in life. This is not meant to be a buck up or shut up comment, it's just that you can't improve your life until you change your outlook on things. You won't be able to move forward on things until you confront your feelings and accept your position to move out of it.

To answer your question, yes. My 30's were a mess with a divorce, a parent with dementia, a kid who had a unknown behavior problems they said was autism, and trying to keep my dad's business running all while maintaining a full time job. You can get better, but you need help doing it and have to actively accept you aren't all alone.

100% to the above and I would look specifically for Cognitive Behavioral Therapy which specializes in treating distorted thinking. It rescued me from my early thirties and I haven’t been depressed since. Our brains are wired to generate stories and narratives around everything, we can’t help it, and sometimes those narratives are distorted but cause damage and like a scab, we keep reinforcing and picking at them. Learning to recognize when you’re doing this and to stop is a skill like riding a bike, and a good therapist can help. Group therapy also helps because you can see other people going into these catastrophic narratives that look absurd to you and give you an idea of some of the same distortions you might be imagining.

Then other thing is, no matter how smart you are, you can’t debug yourself, you need other people. If you have a distorted negative feeling of yourself, then when you try to fix yourself, you’ll be more inclined to feel something isn’t working or you are doomed the first time you hit a roadblock or relapse.

And ultimately sometimes medication can help you get through the initial hurdle of such negativity, another reason you need to see a professional to evaluate this.

Go check out YouTube and Wikipedia for some cognitive behavioral therapy sources to see if it might fit.

> Then other thing is, no matter how smart you are, you can’t debug yourself, you need other people.

This is very true, and not always realized.

Another way I heard it said which is easy to remember: "You can't read the label from inside the bottle."

An alternative to CBT that you might want to consider is Internal Family Systems. I find it to be a more holistic and compassionate form of therapy that respects your entire internal system.

Sometimes we have internal parts that need love and care more than they need lecturing on cognitive distortions.

CBT is effective for many people which is great, but there are other options.

CBT didn't really work for me, but I have found IFS to be a bit more useful, as well as another framework called ACT (Acceptance and Commitment Therapy).

Personally, I found it helpful to read some of the books on these and related concepts, as a supplement to therapy. Also, it can be a frustratingly slow journey.

Second the advice for Cognitive Behavorial Therapy, looks like the best fit in this case.

Another vote for CBT. CBT has made a big difference for me, helping me to find my way out of some very negative patterns of thinking, and allowing me to feel real joy, despite a number of ongoing difficult circumstances in my life. I'd recommend it to just about anyone, at any age.

I didn't go through CBT with a therapist. I just read the first few chapters of The Feeling Good Handbook, then tried to establish a habit of confronting my negative feelings, and the thoughts that were feeding them by identifying the distortions in those thoughts.

YMMV, but it may be worth a try.

CBT helped debug my thinking in very analogous circumstances to OP (30+, hit hard by events in life plus somewhat traumatic past), warm recommendation as well.

My #1 recommendation of something you can do today: exercise.

- builds a routine

- more effective than antidepressant drugs

- helps you sleep

- provides time for reflection

- forces you out into the world

- in the long run makes you better looking

- builds a work ethic

- builds self esteem

- helps you learn to concentrate

- gives you more energy to do things

- it develops motivation

- it reduces stress

If you have time for it, do it twice a day.

Especially you who seem to be in decent health (you're not american so I assume you're not morbidly obese or other issues).

Do 20 minutes of light exercise a day. Walk. If you have a bike, go bike. Too cold out? Find some stairs and just walk up and down them for 20 minutes.

Just do light exercise for a month, then think about goals.

Otherwise, 42 isn't too late to reproduce for a male. You appear debt free? Guess what, you're richer than most american.

Exercise, sleep, diet, and hydration are definitely important first steps. However, I felt a unique sense of pain when I was doing all of those things and still feeling empty, miserable, and angry.

I guess what I'm getting at is: don't beat yourself up if you go through the checklist and still feel bad. That's a sign that there are other external or internal factors that exercise won't address, and that therapy could help with.

> you're not american so I assume you're not morbidly obese or other issues

Had to slip in the insult, didn't ya?

> You need to see a therapist

You should reword that. Otherwise how did humanity last this long? Psychotherapy is less than two centuries old. You should instead say something like, "One option is to see a therapist."

There are friends, elders, books, and a number of other ways to climb out of a mental rut. Traipsing "Psychology Today" for a therapist who will charge the insurance $150 for 40 minutes of a session, through Zoom no less, with your $40 co-pay after deductibles is such a commercial approach to what is fundamentally a human problem.

You know a very modern problem? You can't sit easily and talk with friends over a drink about your issues and have someone give you constructive advice. Everyone is remote, busy, prefers chatting online, and as a result a lot of loneliness manifests as "Oh my god, what am I doing with my life."

It's worth considering a therapist as similar to a medical intervention - yes, good eating, clean living, and regular exercise can keep you healthy, but after a very long time of not doing so, it's possible to find oneself too far down the road for that kind of change to sufficient on its own. Similarly, the help of friends, family, etc. can do wonders for one's mental health, but after a very long time of neglect, that can be beyond one's reach.

I say this as someone who rather successfully turned things around with a therapist - I simply did not have it in me to have those conversations with others and I didn't feel I had the relationships or support to do so (in retrospect I probably did, but that's the thing about mental health).

I don't think your diagnosis is wrong, particularly - there's a lot in the modern world that promotes alienation, feelings of low self esteem, and depression, but I think a lot of people find themselves at the bottom of the well before realizing quite what's happening and without the support structures to get out on their own.

(Edit just to note that, like physical health, mental health is not just the consequences of one's own actions - both genetic predispositions and unexpected life events can necessitate professional intervention by no fault of one's own. It's not what we're talking about, but just so nobody takes my post to be a psalm from the church of the self-sufficient.)

I don't disagree with anything you've said, and I don't think therapy is useless. Especially when one is past a point where there are few other options.

It's just a sad state of affairs that there are so few other options for people. I continue to pin the blame on the remote-first nature of society, which seems to make in person interaction secondary. It perpetuates loneliness which perpetuates mental health issues.

Humanity "survived" this long, many people did't make that cut, and many of those who did lived in misery, denial, or in the comfort of alcholor and/or drugs. IMO the cost of a couple of sessions to see if it works for you is better than not giving it a shot.

OP: Life can be good and does indeed gets better, if you are not in a good place, please do talk to someone, try to make a change, no matter how small, and stay strong.

Yes, too often "You need to see a therapist" is just a euphemism for "I don't want to listen to your problems."

This is an important data point and a general trend toward the cheapening of human relationships. Friendship means something very specific, and for a lot of people now it means only the superficial. Anything deeper than that is actively discouraged. I think of those surveys about friendship took this kind of friendship into account. The number of people without any friends at all would be outrageously high.

Spo on, in this isolated atomized western reality, the end result is posts like that and therapy suggestions as replies.

How do u find a therapist? I’m a bit weary to discuss super personal things with someone I don’t know even if they’re a professional.

How can I find someone I trust and is actually good? Not like the movies where the clock is up and ok next issue.

My work offers a mental health service but I’ve looked at their TOS and no thanks.

Sometimes I feel like just suspending the world background process and being still would be nice. But I don’t have sudo.

I have found this to be a good, if somewhat unreliable way to find therapists. But it definitely is a real resource that shouldn't be sandbagged with downvotes.

Just to add to the other comments: this is how I found my therapist after other sources failed. Everyone was too busy for a new patient, but I reached out to several from here and one of them said he had an opening for 40 minutes bi-weekly, starting at the end of the month. It was better than nothing (I’m serious, it was a huge boon!) so I took it.

I immediately told him I wanted more time, and within a couple of weeks, he had other openings in his calendar and we established a cadence that works much better for me.

All this to say that, psychology today is a legit resource that works, and just getting your foot in the door with any therapist is the most important thing you can do to get treatment. It’s not easy, but it can be done, and for me it has been worth it.

And A decent therapist is better than an ideal one. Just getting started talking to someone is key.

It depends. If you're in a serious rut I seriously think a therapist could make it worse. You need the right fit who your brain is not going to dismiss the moment they open their mouth.

How would you find the right therapist in that situation?

that's the question, ain't it? Telling people to just suffer through terrible therapy probably ain't the answer

I think the question to ask is: is this therapist helping me or not? If not move on to another one.

To add another vote to the pile, I found a good CBT couples therapist this way. A year later it’s worked out very well.

I found my therapist exactly like this and I have been with him for a few years. I was judicious with narrowing the search results and then further combed through each one meticulously. My wife tried 3 or 4 until she found one that clicked. I consider this list to be vastly superior to a better help etc. which I have never had luck with.

Seeing a bad therapist is worse than not seeing a therapist. I'd avoid online directories that are known to be gamed.

Seek referrals from real people in your area.

>Sometimes I feel like just suspending the world background process and being still would be nice. But I don’t have sudo.

You absolutely can do this if you go on a meditation retreat. I went to https://www.dhamma.org/en-US/courses/search though I am sure you can find other schools of meditation. My experience was that you are not allowed to talk for the duration of the course and just focus on breathing & meditation (10 days in my case). It brought a great deal of calm and focus into my life.

Given OP's user name, I suppose he is in Germany right now. If you want to find a therapist, there's several ways:

1. Talk to your health insurance; they often have scheduling services

2. Talk to the Kassenärztlicher Bereitschaftsdienst of your state, e.g., Bavaria has this on offer: https://www.kvb.de/service/patienten/terminservicestelle/ter... If you don't know where to head to, call 116117. Easiest way.

3. Go to your GP - he can guide you through this or can forward you to a psychiatrist

4. Use the online service from the association of psychotherapists: https://www.psychotherapiesuche.de/pid/ersteschritte

If you have suicidal thoughts, search for a local Krisendienst Psychiatrie (https://duckduckgo.com/?t=ffab&q=krisendienst+psychiatrie&ia...), they can help you immediately.

The most important thing that OP has to learn is that he is not alone, there are professionals out there that can help you. But you have to make the first step.

In Germany, if you have public insurance and your GP prescribe therapy to you, but all public therapists are fully booked, you can take sessions with a private therapist and the public insurance is obligated to cover you.

Here is a good (long) guide in English: https://www.bptk.de/wp-content/uploads/2019/09/2019-09_bptk_...

Try a few. Go see one, make it clear you’re looking around. If it isn’t working, say so and move on. They’re professionals, they get it.

You do have to be prepared to be vulnerable to some extent, but if they’re any good they’ll earn trust and develop a working relationship with you that is comfortable.

Source: multiple years of therapy. Definitely worth the effort and the cost.

Absolutely, and I'll add that if you don't like the therapist, keep looking. The quality of the relationship between you and the therapist has A LOT (the most?) to do with what you'll ultimately get out of it.

I remember it being really hard to know what I wanted from therapy the first time I did it which made choosing a therapist feel pretty overwhelming. Had to drop the first therapist I saw after a couple sessions because it wasn't for me (and a good therapist will tell you "you might want to seek out another therapist").

If you really want to, you can read about the different therapy methodologies that therapists commonly use, but as a first-timer I found that to be pretty overwhelming and just reading the therapists' descriptions of the kind of work they do and clients they typically work with ultimately more helpful in choosing someone I could work well with.

Exactly this, a good therapist will focus the first session or two on fit, they want to make sure you both understand each other.

I will caveat by not knowing what country you are in and the norms there, so this is coming from a US centric approach.

A good therapist (but maybe not a good match for you) will also recommend others they know that they believe are a better fit.

> How can I find someone I trust and is actually good?

It's like dating. I think within the first 4-5 visits you'll know if someone is trustworthy and is giving you some insight. Note, they won't be able to give you the really great insights until you feel you can trust them, but they should be able to give you a couple of things to ponder / act upon even in the initial stages.

If you have a doctor, I would start there by asking that person if there is someone they would recommend. It may take a few attempts to find someone you're comfortable with. The first session or 2 will be around both of you figuring out if it's a good fit. It may not be. Most therapists have a bio describing their approach to their practice and their beliefs.

Remember, if you meet a therapist and you aren't feeling it isn't a good fit, that's ok. There is nothing wrong with you (or them), it's just not a good fit. Be honest in your feelings, and don't worry about disappointing anyone in the process. This is about you and what's best for you.

If you go by your GP's recommendation, do not think that if you don't get along with them, that you won't get along with other therapists, or that there's something wrong with you. My GP suggested someone in the same building, and they... were not great, for me. The therapist I found on my own (through looking at reviews and whatnot) was much better.

I have found online services to be OK when I was struggling with a difficult time. Mindbloom, Betterhelp, and Cerebral were fine for what they were. They got me through the first steps for a slight cost. After that, momentum builds. There's no silver bullet.

FWIW, my experiences with betterhelp were absolutely terrible. I had a therapist ghost me, and another one that would respond with answers so generic I would’ve been better off talking to a chatbot (I sort of suspect that’s what I was doing).

I am not surprised. I had to switch therapists a few times. Ultimately I started to remember my self care strategies and stopped seeing a therapist. Though the medicine is a big help.

I still believe that any therapist is better than none, because it forces you to do something, which will change the narrative from "it's hopeless" to " I'm working on it just haven't found the right match". That shift alone is worth the cost.

If you live in a metro area, look for hospitals that run CBT/DBT/group therapy sessions. That's another way to get started. If you have insurance, that helps.

If you don't have insurance, consider looking at your background and find a 12-step program that fits. ACA (adult children of alcoholics, but it also considers family dysfunction) is one example. It doesn't benefit from having a trained therapist, but it's effectively free group therapy.

> I’m a bit weary to discuss super personal things with someone I don’t know even if they’re a professional.

You don't have to unpack everything in the first session. Generally you want someone who is trying to build a one-on-one relationship with you where you feel comfortable doing this.

> Not like the movies where the clock is up and ok next issue.

I mean, all appointments end at a certain time and then you get up and leave.

> Sometimes I feel like just suspending the world background process and being still would be nice.

You could try meditation. I do both therapy and meditation.

My SO is a therapist. Something to keep in mind: Many quality therapists have stopped taking insurance due to the influx of folks seeking care coupled w/ insurance tightening what they pay out.

I'm certain there are plenty of good therapists who will take their time with you at the discount implied by insurance, but you're more likely to get that experience if you're paying full rate.

Or sometimes they don't submit on your behalf, so you have to do the paperwork to submit to your insurance for whatever amount your insurance reimburses, depending on your plan.

Somebody wrote that OP is in Germany. Here are some notes I compiled for (expat) friends and coworkers on:

How to find how to find a therapist in Berlin (Germany): https://docs.google.com/presentation/d/1YQYTXBkypxc1DaCRWIjk...

> How can I find someone I trust and is actually good? Not like the movies where the clock is up and ok next issue.

In reality, you don't really know the kind of people you'd trust to talk to in the first place, you don't really have an informed opinion. Just jump in feet-first, don't think about. You just need someone to talk to ASAP and any decent therapist is your first step. Just try it, there's nothing to lose whatsoever.

>> there's nothign to lose whatsoever.

Except hundreds or even thousands of dollars you may or may not have to pay the counselors until you find the right one. I don't mean to be discouraging anyone from getting help, but keep in mind the counselors are not fungible, and, at least in my experience, many of them are useless or just plain weird. (This is not to stereotype, just stating the reality.) I wish there was a way to prefilter them out, but it is such a subjective field and the treatment options are highly individualistic.

I would suggest any kind of community involvement with people you have an affinity for. In person, preferably. That brings on a set of new problems, but at least it will help get you out of yourself and away from too much navel-gazing.

I've had several. The best one I had was a life coach without all the standard creds. The next-best one was in a hospital (outpatient) group therapy program that taught CBT.

Keep an open mind, but... it takes looking. I've had therapists with all the right degrees who were... meh. Well-meaning, but just not that good at it.

Unfortunately, this isn't a zero-effort path. You have to look, and fire therapists who aren't doing what you need.

Katie Morton has some good videos on how to select a therapist and red flags to beware of.

I used TherapyDen to find the only therapist I saw (so I'm no expert). But lots of therapists there have videos so you get a sense of who they are and what they focus on. I did enjoy the therapist I ended up seeing for a year.

https://www.therapyden.com/

i found my therapist via a therapy app, which we both left long ago. Apps like BetterHelp and TalkSpace can be very hit and miss, but they're a place to start, and can serve as good matchmaking services.

Be prepared to pay out of pocket, my insurance pays about half of what my sessions cost. You get what you pay for. You don't want a therapist who is stretched too thin, overworked, or financially struggling themselves.

Also, ask friends and family, you may know more people in therapy than you realize, and talking about MH with people you know is incredibly helpful.

If you have a good PCP, ask them for a referral both to a therapist, and consider an IOP - an Intensive Outpatient Program. When you're trying to get out of crisis, it can be helpful to have more than just a weekly or biweekly session. I am in such a program now, it includes group therapy every day (I can choose which groups) and more intensive individual therapy and case management.

The particular program I am in also does ketamine therapy, which can help to rewire your neuropathways so that behavioral changes are more permanent. There are some online programs - Better U and Mindbloom come up in a quick search - which will offer this and other IOP-like services remotely, though I'm not sure how they compare to traditional IOP.

Above all, seeking help in any way that you can will make you feel better and I am personally proud of you for coming and asking a bunch of strangers for help. It shows a readiness to take on your challenges.

Good luck on your journey! <3

> How do u find a therapist?

In Ireland, at least, you ask your doctor for a recommendation

There is no harm in trying out therapists. Don't be afraid to fire them and find a new one. They shouldn't take it personally. Much of it is about fit and you need to find the right person for you.

The worst therapist I ever had referred me to the best therapist I ever had. If a therapist gives a shit about you, they'll help you find a better fit.

Therapy can save your life.

The professional is there not to be a regular person to know, but someone to who you can emote and feel openly your hardest things you hold inside. This expression of those things makes them less haunting and distracting inside yourself. This technique does not necessarily fix your material problems, but it allows you to clear the way within you to take them on.

It is not for everyone, and it is worth a try when you are feeling hopeless.

There are lots of good online therapy things now. Although I’d recommend doing in person if you can because the latency of emotional exchange is much higher in the space of the world. Even still the online work can be hugely beneficial.

Even if your worldview has left you bereft, your body deserves a chance to reformulate your mind for this opportunity at existence.

First of all don't suspend your background processes with sudo, that is only going to prevent the money from coming in everyday... then you've got Google maps you can type in social worker near me or psychiatrist near me or behavioral health near me and it will point you in the right direction.....

Therapy being limited to a scheduled window of time is a big part of how therapy works. You're paying a professional for their time.

Referral are probably best. Seek people in your area in that profession and just ask anyone if who'd they recommend.

You need to fix your brain. Spending 50% of your income/spendings for at least one year on therapy is the minimum you can do.

It is just like a broken leg you need to get it fixed you have no choice.

Find one specializing in CBT, or similar forms of therapy shown to be effective (3rd-wave CBT such as MCT). You can also just pick up a CBT workbook and do the exercises yourself. The only advantage a therapist has over this is "talking it out" - you should be capable of recognizing and correcting distorted negative thinking with a therapist guide / workbook. This is why online therapy has been growing in popularity, they just regurgitate the principles.

You can do this free of charge just by visiting the library, or finding pdfs online.

I know what CBT is (well, I mean, I've heard term) but what is MCT? Also, I would say that a (good) therapist is quite like a (good) coach/personal trainer - someone who keeps you accountable and committed to a course of treatment/training. Many people could probably do these things by themselves, but many others struggle to keep it up for one reason or other. As an analogue I had a couple of very bad PTs and then went to the gym with an experienced friend and felt very motivated as he encouraged me and helped me through rough spots. Made the most progress doing so. This is not to say going it alone is bad - you need to be able to sometimes.

> MCT

Metacognitive Therapy. Effectively, when dealing with persistent unwanted thoughts, it teaches you to let them pass without judgement / evoking response, and to divert your attention elsewhere. I find that this complements CBT well if one has already done the work of recognizing that some thoughts are unrealistic distortions. Proponents of MCT seem to bash CBT needlessly; they needn't be mutually exclusive, and at any rate, evidence suggests that CBT is generally effective (and there's a much larger body of it than for MCT).

> someone who keeps you accountable and committed to a course of treatment/training. Many people could probably do these things by themselves, but many others struggle to keep it up for one reason or other.

It depends on preference and self-efficacy, notwithstanding that intrinsic motivation is necessary whichever way. However, most people don't seem to realize that self-administration is an option, and walk away from the prospect of therapy entirely if they deem it too costly.

The other problem is, as with personal trainers, whether you'll have a good one is a roll of the dice. Trainers have a perverse incentive to divert people to use machines and away from compound movement exercises like deadlifts. Similarly, many therapists don't offer much insight or homework. And all the while you can leverage the most powerful approaches by yourself at zero cost.

Seeing a pro is still a decent heuristic, most people will want to avoid the labor of doing research which can be daunting, tiresome, and is a skill in itself. Pressing the "just tell me what to do, here's money" button is arguably more optimal depending on the circumstances.

I second that, I would suggest move to a larger city and get a job and therapist there (looks like the OP is from Germany, which I would personally prefer to US).

And regarding to life goals, wife and kids in particular, although I have decided not to have a family, so take my advice with a grain of salt, but I think there are many single mothers out there who would appreciate a stable and solid partner with 2nd income.

One thing to note is that while Germany is much better if you need social services, it's much easier to move between classes in the US. It's very hard to move up in German society without the right social circles which are also much more exclusive than in the US or London.

That said, while therapy is one thing(and very hard to find someone that actually helps you out of your misery instead of reinforcing it), I'd maybe suggest creating a fixed schedule. Some basic cardio sports at a fixed time and day once a week(if that is too much once every two weeks). Ideally a group practice that gives some social pressure. It's much harder to get out a tough spot when you're alone. Maybe a beginner Capoeira class. No real requirement to socially engage if you don't want to, but warms your heart nonetheless.

And maybe one usergroup of some sort once a month. No need to engage with people. Worst case, you just listen to some talks and get free Pizza.

One thing that's very important in Germany when getting help is to never EVER say that you have suicidal thoughts. The moment you do that you slide into a bracket out of the social system that you can never get out of on your own. Any doctor or psychologist may now force you to take medication or put you in the asylum whenever they chose.

>>One thing that's very important in Germany when getting help is to never EVER say that you have suicidal thoughts. The moment you do that you slide into a bracket out of the social system that you can never get out of on your own. Any doctor or psychologist may now force you to take medication or put you in the asylum whenever they chose.

That is terrifying. Those medications are mediocre in the long-term. If you have a problem with a side-effect and they deem it trivial, you may be forced to take a medicine for life. Some of the alternative approaches to medicine are proving far superior for moderate level depressions (which can still be suicidal ideation).

It's as terrifying as it is wrong. Nobody ever forces you to take meds or being put into an "asylum". ESPECIALLY in Germany. I have no idea where this idea comes from but it is not true at all

Disclaimer: I have two very close friends and one relative who struggled with suicidal thoughts. None of them were put on meds against their will, or put into an "asylum". There was staionary therapy though, sometimes multiple ones, but not against their will

It's shocking that people write that kind of misinformation and it is upvoted so highly at the same time. The threshold to be forcibly put into a closed psychiatry ward is enormously high.

In a practical sense, is it not a similar case in US? The moment you are flagged in a hospital system as a suicide risk it follows you.

That last bit probably applies to most countries, not just Germany. Though keep in mind that’s a judicial process triggered by doctors and enforced by police, most people killed by police are in that “bracket” and nobody gives a flying fuck about it.

Is therapy better in Germany? I live in Hamburg and the waiting list is more than a year for therapy. I was under the impression that it is somewhat faster in the US

When I lived in the UK they wouldn’t offer me even a waiting list

Go private if you can afford it. NHS therapy in the U.K. is basically impossible to get for most people, but there are many, many good professional therapists charging £40-£60/hour. Once a week or fortnight, it’s worth it.

Unfortunately I live in Germany now where private therapists are far more expensive than that. More like 100 to 200 an hour. When I eventually return to the UK I won’t bother with the NHS again

As I posted above, German public insurance is required to cover therapy if your GP prescribes it. So you can get private therapy covered if public therapists are too busy to take you.

The process is roughly like this:

* GP prescribes therapy.

* You call seven public therapists who are busy and note their information and when you called. There's a specific form for this.

* You find a private therapist that satisfies certain conditions (e.g. degree granted in Germany) that is a good fit for you, and your public insurance is obligated to pay for your care.

Here's a long guide on it:

https://www.bptk.de/wp-content/uploads/2019/09/2019-09_bptk_...

It’s for complicated reasons but I’ve been informed that’s not possible in my situation because I don’t speak German

Ask if they will take a sliding scale, most will.

Also if you can provide tech stuff (like a website or what not) see if they will trade in kind services.

You can find therapist from other countries if you are comfortable speaking with them in english through video call. It may not provide the same experience but it might be better than the alternative which is no help.

I would check out eastern europe or Asia. They will cost around $15-25/hour.

Yes, you can easily find a meeting for the same week (maybe same day) in the US. The downside is the better ones are picky about taking insurance (i.e. you might have to pay 40% yourself and then submit the bill to your insurance company to get reimbursed the 60%) because most insurance companies pay really low rates for mental health. From what I've heard Aetna is the best.

Having worked in Germany's healthcare system, specifically in Hamburg, I can only see one trajectory. Worse. The policymakers are deeply corrupt and doing everything they can to squeeze more money out of patients.

You can book therapists online next week in the US, but they're not cheap.

> The policymakers are deeply corrupt and doing everything they can to squeeze more money out of patients.

The problem is more related to the problem of „fixed budgets“. Every health practitioner in Germany’s public health system receives a fixed quota of money per quarter. In regions with few doctors and therapists this means practitioners would operate on a loss if they accept too many patients. That’s why you wait forever for a doctor if you got bad luck.

It’s an effect similar to the case a private good is regulated to have a maximum price. This way politicians create a shortage of that good. You can have a public system where everybody is forced to have insurance (or receives welfare if one cannot afford it) but where healthcare prices are allowed to float more freely. But German policy makers rarely understand basic economics (or don’t care) — but they are acting on good intentions.

That being said: There was a time I needed to see a therapist (after getting through a divorce) and didn’t have any trouble finding a therapist around the corner within two weeks. Five hours were covered by public health care provider immediately, then the therapist had to write a proposal and another doctor had to sanction it as others described. The proposal was smoothly granted.

Bottom line: Your mileage varies in Germany.

I've been able to get a therapist appointment within a few days in the US.

I think the US has a stronger therapy culture. It reminds me of how in the US pain relief medicine is much more common, while in Germany a lot of people won’t even take paracetamol

Oh yeah definitely. In online US circles it often seems like almost every other person utilized therapy at some point, in Germany it’s pretty taboo, i.e. therapy is for the mentally ill. There are various euphemisms for totally-not-therapy therapy (e.g. coaching or supervision) in German because if you say you did or do therapy you instantly go in the loony bin.

Sorry, but the last bit is complete and utter bollocks. Never, ever don't mention this. Please delete this dangerous misinformation that might keep people from looking for help in times of need.

Parent appears to be giving a practical suggestion on how to literally survive in a society. If it is true that it flags you, then why would you qualify it as misinformation? For the record, I have almost no knowledge of how Germany healthcare works in that regard.

There is no flagging. Who should flag you, and where? I know quite some people that were in these situations, no one experienced any such consequences.

Regarding the last point, that's shooting pretty low imo. Definitely a range of women out there between 25-35 who might be a catch, you just don't want to be desperate first.

I mean I don't know why people keep saying it's too late to have kids if you're 43. You could have a 20 year old by age 65, which is the time you could retire and have them move out after they get a job.

Not sure why you've been downvoted. This is absolutely true.

I would however be careful equating having kids to being successful in life. At best, they can be a joy to have. At worst, they can be little sources of chaos and stress that you can pass your own worst traits to.

Can't you deselect your worst traits with IVF?

You could carefully choose an egg donor and a sperm donor who don't exhibit your bad traits. And then pay for someone else to raise the child. Dodge nature and nurture

I had my child at 45. I recommend earlier if you can but in my case it’s been amazing.

A six month series of weekly sessions with a Cognitive Behavioral Therapist had a transformative impact in my life. He helped me see some of the actions I was doing more clearly and helped me develop the skills to change. In our sessions we focused on one small part of my life, but I’ve felt the impact quite broadly and still think of him and those conversations regularly, especially when I am struggling. I have at times seen other therapists with less helpful results, so it’s with finding the one that fits for you.

I don’t believe any life is past its time. We all follow our own twisting paths, and it is an easier path when we don’t have to face it all alone.

It really sounds like your main problem is your depressed. So I'd get a therapist, get on medication, and try some things one the urls below.

And to expand on that, if you're not vibing or getting results from one therapist see another one. Don't give up after seeing just one. I know plenty of people that didn't see much improvement after one therapist but did well with others.

Look into medications, they are a lot easier to stick to than seeing a therapist especially if you're depressed. Even if the first drug doesn't work try another one. The non-response rates to a single medication are much smaller than if you didn't respond to one you try another one.

In the process get started with this book. https://www.amazon.com/Cognitive-Behavioral-Workbook-Depress...

This website has a lot of useful information too. (Written by a psychiatrist) https://slatestarcodex.com/2014/06/16/things-that-sometimes-...

I agree this is an important place to start, but it might not be feasible given the situation they're starting from now.

It might make sense to take "under-" employment with a company that offers good health benefits, which would at least provide income and insurance to buffer the cost of therapy. It might be helpful to think of it as a "launchpad" or "staging" job. It can also be an opportunity to exercise the muscle of befriending new people (coworkers, regular customers).

In the US, Starbucks and Trader Joe's are popular launchpad choices of employer, at least in my metro area. There might be similar ones in your current home country, if it makes more logistical sense to stay local.

Yes, I read this and was thinking therapy from the start. I was never against therapy but finally pulled through and my mood and outlook have improved dramatically over the past six months thanks to my weekly therapy sessions.

OP’s username seems somewhat German so I would cordially invite OP to make use of our pretty decent Krankenkasse system that makes it a relative breeze to get therapy sessions. Shop around if you don’t vibe with your therapist.

I don't think you're wrong, but it's worth mentioning that you can't outlook-change your way out of having executive dysfunction. Recognizing the problem is the first step, but getting help comes soon after.

> a kid who had a unknown behavior problems they said was autism,

Curious to know how that shook out. Did they get a different diagnosis eventually? Did anything in particular help?

I'm sorry but how is this helpful? Even if you're actively employed that's a tough cost-benefit decision.

Literally there is no greater cost than not being able to live/earn a living/achieve any of your goals.

So of course the cost is worth it.

With every passing day, I am becoming more bitter, angry and disillusioned. I don't want to live like this anymore, but I don't know how to even _start_ thinking of ways to get myself out of this hole.

The parent comment about therapy is correct (I regret not getting some myself), but I wanted to address this line directly.

I was stuck being overwhelmed from 2003 to 2019 after the death of a friend, because I had a spiritual awakening but denied it. I tried to satisfy my ego and win the internet lottery and gain external recognition of success which never came. So I lost the better part of 2 decades just going through the motions, utterly exhausted.

I had another spiritual awakening climbing out of burnout and surviving through the pandemic. This time I watched the world wrestle with every existential truth that I had suspected but which had been suppressed by the might of economics steamrolling everyone until that point.

Now I feel that reality is akin to a dream, or at least a Matrix like the movie. There are logical rules we must follow on the micro scale in the day to day where we push atoms around for income. But on the macro scale, it's more like the universe reads our mind and lays a path for us to follow whose main goal is to put us through the wringer for our spiritual growth. That can be as painful or as effortless as we choose. Western culture has no real description for this outside of religion, so all but denies its existence. But it's deeply connected with karma/sin and how we've integrated our shadow self with our outward existence.

Basically the stories I had told myself for most of my life were no longer enough to sustain me. My inner monologue had became toxic like the line above, a false exaltation to cling to when I couldn't face the road ahead of me. Here is an alternative way to write the same sentiment:

I was struggling for a long time but am grateful for the lessons that pain has taught me, even though I can't continue to cling to that pain any longer.

I found that most of the code in my brain had been co-opted by negative self-talk, to the point where it no longer worked and I lost my executive function. It was like I had a stroke and the part of my brain that controlled motivation was no longer there, or worse, actively talked me down from starting any task. I believe now that my subconscious intervened and broke the negative feedback cycle I was trapped in where the harder I tried, the harder I failed.

Once that happened, I finally understood that my mind is not my soul. My physical body and even my thoughts may suffer profoundly (or be elated) in the day to day, but I mostly observe that process playing out now. I don't subscribe to external meaning anymore. I choose what's meaningful. Because meaning isn't objective, it's subjective.

Now I meditate and have faith that I can handle life, even when it doesn't turn out the way that I want. I've found that practicing non-attachment has a funny way of revealing what's really important. Mantras help too, like aligning with heartfelt causes, for example service or being of service to others. Kind of like, strengthening the love inside to give love to others who need it. And allowing myself the same dignity to receive love. My struggles became training, my successes became miracles. And reality seems to be shifting towards this more integrated physical/spiritual whole with divine timing.

Hope something in this helps you on your journey.

Unfortunately finding a therapist in Germany is near impossible even in a big city, I’ve been on the waiting list for almost a year now with no sign of end and I live in Hamburg which is one of the richest cities in Germany

Also living in Hamburg. Have you tried 116117.app to at least get a first appointment? I got lists and lists full of phone numbers, always got rejected or waitlisted, but found a therapist quite quickly near me using this first talk. Nobody told me about this, had to search a lot. I hope this helps.

Getting the first appointment was easy, it’s the follow up treatment that has the extremely long waiting list

Many will offer a first appointment for preliminary diagnosis and to check if they can help you, but then you are put onto the waiting list

Could you try one of the remote services like Better Help? (I have no idea if they have good therapists, I just see their name a lot lately).

I do not recommend remote therapy one bit.

I don't think the basic talk therapy apps are very helpful, mostly because they have a lot of low quality therapists and matching is terrible. But I disagree with remote being inherently bad (especially compared to a year+ wait). I'd encourage OP to see if they can access any university trials for remote CBT apps. I'm aware of studies that showed promising results in the recent past but I don't know what became of any of them since COVID (which really should've catalyzed this sort of thing).

Maybe for minor things it's good. But for depression and serious mental issues absolutely not.

For example you can't do analysis without being physically present with your doctor [1].

[1] https://en.wikipedia.org/wiki/Psychoanalysis

> For example you can't do analysis without being physically present with your doctor

Why not?

Psychoanalysis is pretty much discredited as a scientific discipline, nowadays.

There's also a lot of evidence of remote therapy being just as effective as in-person therapy.

Citation needed. Psychoanalysis is widely practiced and it’s efficacy has been repeatedly scientifically demonstrated.

> Citation needed.

Sure, I will cite the Wikipedia page on Psychoanalysis, which itself has many citations which you can follow:

1. "Psychoanalysis is a controversial discipline, and its effectiveness as a treatment has been contested"

2. "Linguist Noam Chomsky has criticized psychoanalysis for lacking a scientific basis."

3. "Evolutionary biologist Stephen Jay Gould considered psychoanalysis influenced by pseudoscientific theories such as recapitulation theory."

4. "Psychologists Hans Eysenck, John F. Kihlstrom and others have also criticized the field as pseudoscience."

5. "Philosopher Frank Cioffi cites false claims of a sound scientific verification of the theory and its elements as the strongest basis for classifying the work of Freud and his school as pseudoscience."

6. "Karl Popper argued that psychoanalysis is a pseudoscience because its claims are not testable and cannot be refuted; that is, they are not falsifiable:

....those "clinical observations" which analysts naively believe confirm their theory cannot do this any more than the daily confirmations which astrologers find in their practice. And as for Freud's epic of the Ego, the Super-ego, and the Id, no substantially stronger claim to scientific status can be made for it than for Homer's collected stories from the Olympus."

7. "Imre Lakatos wrote that "Freudians have been nonplussed by Popper's basic challenge concerning scientific honesty. Indeed, they have refused to specify experimental conditions under which they would give up their basic assumptions.""

8. "Scruton nevertheless concluded that psychoanalysis is not genuinely scientific, on the grounds that it involves an unacceptable dependence on metaphor."

9. "The philosopher and physicist Mario Bunge argued that psychoanalysis is a pseudoscience because it violates the ontology and methodology inherent to science. According to Bunge, most psychoanalytic theories are either untestable or unsupported by evidence."

10. "Cognitive scientists, in particular, have also weighed in. Martin Seligman, a prominent academic in positive psychology, wrote that:

Thirty years ago, the cognitive revolution in psychology overthrew both Freud and the behaviorists, at least in academia.… The imperialistic Freudian view claims that emotion always drives thought, while the imperialistic cognitive view claims that thought always drives emotion. The evidence, however, is that each drives the other at times."

11. "Historian Henri Ellenberger, who researched the history of Freud, Jung, Adler, and Janet, while writing his book The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry, argued that psychoanalysis was not scientific on the grounds of both its methodology and social structure:

Psychoanalysis, is it a science? It does not meet the criteria (unified science, defined domain and methodology). It corresponds to the traits of a philosophical sect (closed organisation, highly personal initiation, a doctrine which is changeable but defined by its official adoption, cult and legend of the founder)."

12. "Richard Feynman wrote off psychoanalysts as mere "witch doctors""

13. "Likewise, psychiatrist E. Fuller Torrey, in Witchdoctors and Psychiatrists (1986), agreed that psychoanalytic theories have no more scientific basis than the theories of traditional native healers, "witchdoctors" or modern "cult" alternatives such as EST."

14. "Psychologist Alice Miller charged psychoanalysis with being similar to the poisonous pedagogies"

15. "Psychologist Joel Kupfersmid investigated the validity of the Oedipus complex, examining its nature and origins. He concluded that there is little evidence to support the existence of the Oedipus complex."

> Psychoanalysis is widely practiced

Astrology is widely practiced as well. Doesn't mean it's scientific.

> and it’s efficacy has been repeatedly scientifically demonstrated.

That is a very controversial statement within modern psychology.

Although I have no doubt that most psychoanalysts believe that, just as homeopaths and other pseudoscientific practitioners also believe that their disciplines are scientific.

Chomsky? He's a linguist, what does that have to do with Psychoanalysis?

Feynman? He's a physicist, what does that have to do with Psychoanalysis?

This list very much sounds like something the marketing team of an online therapy startup would put together and post to Wikipedia and tell their colleagues to contribute to.

> Chomsky? He's a linguist, what does that have to do with Psychoanalysis?

He's also a philosopher, historian and cognitive scientist. He has received a Membership of the National Academy of Sciences (which is an award given to scientists), a Kyoto prize in Basic Sciences, a medal from a German academy of science, an American Psychology Association Award for Distinguished Scientific Contributions to Psychology, etc.

These are relevant areas and merits with regards to judging whether a discipline is scientific or pseudo-scientific.

> Feynman? He's a physicist, what does that have to do with Psychoanalysis?

He is one of the most famous scientists in the world, had an extremely significant scientific career, won a Nobel prize in a scientific area and a National Medal of Science.

If you don't know why such a person would be extremely qualified to distinguish a scientific discipline from a pseudo-scientific one, I'm deeply sorry for you.

Also, don't ignore all the other experts in the fields of psychology, psychiatry, cognitive science, philosophy, history, etc. who arrived at the same conclusion.

Although, I am interested in knowing why you think that you are more qualified than these people to judge whether a discipline is scientific or not.

> Although, I am interested in knowing why you think that you are more qualified than these people to judge whether a discipline is scientific or not.

Because this doesn't pass the smell test.

You can always provide positive evidence for existence of something if you find a hole in provided evidence then you should then be extra careful believing the hypothesis. Or in Black Swan lingo skeptical empiricism.

I have to be honest, none of those are particularly convincing, and spamming a bunch of disconnected quotes from a Wikipedia page isn’t a great argument

> I have to be honest, none of those are particularly convincing, and spamming a bunch of disconnected quotes from a Wikipedia page isn’t a great argument

It was not an argument. It was an answer to the parent poster which requested a citation. Which is why I gave him citations.

And if such a large list of citations from many experts in the fields of psychology, psychiatry, philosophy, history, cognitive science, etc, including many scientists and hell, even (at least) one Nobel prize winner, doesn't convince you... then I'm sorry to tell you this, but I don't think there could be anything that would convince you.

And I'm not sure why you think that you are more qualified than all of them to judge this.

I would be much more convinced by a modern meta analysis

The problem is that I’m a physicist so I see a wiki page with a bunch of quotes from people of all disciplines including a physicist who was famously a huge sceptic of psychiatry and I think of all the physics pages that have all these “opinions” that are wrong

Very few of those quotes mention evidence of outcomes of psychoanalysis but only mention very specific parts of it being questionable. I think you’re jumping the gun a bit. Don’t worry, that’s very common among people who are newer to science

> I would be much more convinced by a modern meta analysis

There are many modern meta analysis assessing the (in)efficacy of psychoanalysis and comparing it to other approaches, such as cognitive behavioral therapy (which is the gold standard nowadays) and other approaches, which back my arguments.

I am not really interested in going more deeply about this, but I encourage you to research it, if you are interested. There is a lot of research about this.

And by the way, I am sure that you can also find meta analysis which will tell you that psychoanalysis works. This does not mean that it is necessarily true (or at least, not for the reasons that people think it is true), for various reasons, some of which I'm sure you can deduce.

The problems with psychoanalysis are not just about its (substandard) efficacy. There are many other troubling issues with this practice.

This is why it is important to follow a field of study and what current scientists, field practicioners/experts and academics know (from various disciplines and fields of study, in order to get a consensus as best as possible), and not just read some isolated meta analysis and extrapolate conclusions from it.

> I think you’re jumping the gun a bit.

I think what I'm talking about is pretty well established at this point, it's not news for someone who works in this field.

I suggest you do more research before arguing about a field you don't seem knowledgeable about.

What meta analysis shows the inefficacy of psychoanalysis? Despite being apparently on the side of science, you didn’t bother to cite any actual science. Ironic

> What meta analysis shows the inefficacy of psychoanalysis? Despite being apparently on the side of science, you didn’t bother to cite any actual science. Ironic

Look, if you are so interested in this, why don't you do the research yourself?

I literally just googled "meta-analysis psychoanalysis" and the very first link that came up [1] was, surprisingly, a meta-analysis about psychoanalysis which concluded the abstract with the following phrase:

"In contrast to previous reviews, we found the evidence for the effectiveness of LTPP [long-term psychoanalytic psychotherapy] to be limited and at best conflicting."

I'm not interested in wasting more of my time on this topic, so don't expect any more replies.

[1] https://pubmed.ncbi.nlm.nih.gov/22227111/

Here’s a study from a month or two ago (10 years after your meta analysis) with n=216 and long term follow up showing (high, increasing) efficacy. You seem confused about the conclusions there, that doesn’t discredit psychoanalysis, it encourages further study. And here is further study. You should try to be more rigorous in your thinking.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710086/

See, this is exactly why I didn't want to cite any particular study or analysis.

I knew this was going to turn into this pointless debate.

I even mentioned it in my parent comment that you can always find some study which says the opposite of what I'm saying. That does not refute what I said and it is not how science works.

You have to analyze a bunch of evidence, from many studies and meta-studies together as a whole, you can't just pick and choose the studies that are more convenient to you.

Not to mention that you asked me to cite a meta-analysis (which I did) and then you counter-act with a single study about a single trial.

So here's the thing: I am not interested in you citing me any study or meta-analysis. As I said before, I'm not interested in continuing this discussion.

I was just arguing what I know about this topic and what I've learned from experts (in psychology and methodology, mostly) and my own research.

You can feel free to ignore me or to continue arguing, but I'm not going to answer anymore.

I don't have a horse in this race and I don't want to waste any more of my time.

You claimed psychoanalysis is discredited. You are wrong, and I proved you wrong. Is the debate about its scientific status ongoing? Yes. But you were foolish with your words, and should retract them.

The study you linked is for specific narrow treatment techniques in intensive inpatient psychotherapy, as compared with more typical psychotherapy treatment in the community for people on the waitlist.

There are a handful of problems I can think of for using a waitlist in the community receiving traditional psychotherapy as a control for a group receiving intensive inpatient treatment.

But the article you linked does not support your point in the context of this discussion.

It doesn’t. It only proves there are still people trying to continue their careers in a field they have deeply invested in, in training, education, clientele, and professional network.

Yes it does because it demonstrates its effectiveness. How can an effective discipline be scientifically discredited?

You are no more knowledgeable than me. You just quoted the wiki page lol

I quoted the wiki page because the parent poster requested citations.

It has no relevance with regards to my knowledge.

People always leave out recommending medication. It is most effective to have medication and therapy.

"See a therapist" almost seems condescending even to average people with average jobs.

Did you read the bit about $25K in savings? Or the part about there are "no mental health facilities in the small town where I live"? How's he afford a therapist, time or money wise?

> Or the part about There are "no mental health facilities in the small town where I live"

HN is hugely biased towards people who live in cities. A lot of the posters simply do not understand how a lot of us outside the cities live, and the resources they take for granted that we don't have access to.

For me the drive to the nearest therapist is measured not in minutes, but hours. That's impossible for someone who has to work full time.

There are telehealth options now and while thay arent uiversal or a cure all, it expands the scope of possibility

A therapist is helpful but I would also suggest seeing a psychiatrist.

Clinical depression and mood issues need to be treated with medication. I would recommend finding a psychiatrist and get a referral for therapist from them if you are able to. You would be able to work together with both medication and theraphy to get better. It will take bit of a time to get better but don't be discouraged, OP. Progress will be slow and many goals you might think of may seem unachievable so it's very important you plan small steps and follow through them.

If theraphy is cost prohibited or have long waiting line in your country, from what I know of OP's situation - I recommend getting online sessions from therapist in other English speaking countries who might be cheaper locally.

In my experience, learning proper coping mechanisms, finding new hobbies, getting better sleep, better diet, getting enough exercise, making sure your vitamin levels are in line, were all much more effective than medication. Medication actually made feel worse and more trapped, and I've taken almost every single antidepressant that can be prescribed.

What worked for me will not work for everyone. It's important to try everything that you can and see what works best for you. For me, medication was not the answer.

It's certainly a journey. I recommend checking with both for this reason. If one isn't working out, you would be able to tell which you respond to better. Medication also often take time to work and may need to go through months of experimentation if common prescription do not help. In the meantime, theraphy can act as a strong force in improving your life and vice versa.

You're absolutely right that a therapy isn't THE solution to depression but I feel like it's a good starting point. A good therapist should be able to recognize if OP should be seeing a psychiatrist who then can prescribe the appropriate medication for managing his/her condition.

A halfway decent psychiatrist will also handle therapist referral. I don't see any issue with seeing a psychiatrist first, it's not like they just automatically hand out a prescription. It's actually way more common to see GPs do that for depression in the US.

That said, OP should probably look into both himself, see what the wait time and cost differences are between the two routes in his area.

One possibly significant difference is that psychiatrists tend to charge a lot more.

> Clinical depression and mood issues need to be treated with medication.

How to know someone is American before they even mention "other English speaking countries"

Please don't take HN threads into nationalistic flamewar. There could be an interesting point to make about how different countries and cultures approach mental illness, but snark and internet tropes are exactly the wrong way to do it.

The HN guidelines include: "Don't be snarky." "Eschew flamebait." "Omit internet tropes."

https://news.ycombinator.com/newsguidelines.html

Need is not the right word because it depends on the person. Some can get better with the right therapy alone. Others don't even respond to therapy + meds but might improve with more invasive neurological interventions.

But there are certainly people in our present world who do need meds to get out of the depression hole. There are people that do not respond to therapy alone but do respond to meds with therapy.

I don't think there's anything wrong with your comment, indeed the statement you're quoting is extreme. But I think HN has the tendency to go too far to the other extreme. At the end of the day, clinical depression is very heterogeneous. You need to do what works best for you.

Btw in case it isn't clear how meds are supposed to work in practice - medication for depression is not something you just pop and forget about. Any reputable psychiatrist will include therapy as part of the initial treatment plan, they don't just write a prescription and send you away.

Yes bad clinicians exist, but I think the pill popping trope for psych is way less common than people assume. Perhaps part of the source of this stigma is the role of the general practitioner. It is not uncommon to see random non-psychiatrist MDs prescribing SSRIs or stimulants, and in those cases it's a lot less likely the corresponding behavioral therapy is happening.

Anyway, medication is an absolute life saver for those people who need help in making the behavioral changes to begin with. There is a large body of studies at this point showing that simultaneous meds and therapy can improve depression symptoms more than the sum of their parts. Gold standard practice is to try tapering off of meds after the course of therapy, and more often than not the symptom improvements persist.

OP should get a professional opinion specific to his situation. He shouldn't go with the intention of seeking meds, but they should be something he inquires about. Some of the sibling comments here are acting like needing meds is a lack of will power, which is just as unhelpful as indiscriminately pushing meds.

Ok now look up anti depressant intake levels in europe.

Please refrain from comments that could put people in danger. It is at best careless to say to someone with possible depression therapy may not be the answer.

I have not suggested that. I strongly suggest trying theraphy above. The point of my comment is to also strongly consider theraphy with a medical practioner who will be able to help you using medication or diagnose any issues that a therapist cannot.

A therapist isn't qualified to make any diagnosis or prescribe tests and medication.

100% second that.

Psychiatrists are real doctors with scientific, comprehensive, rigid education in STEM.

Last thing you want is a pseudo PhD from Berkeley who majored in psychology and studied "human rights" as her thesis.

Just keep in mind that therapists are vastly overrated and are designed to help you accept where you are.

Oh well, accepting who you are helps end a lot of internal struggles which leaves you with a bit of leftover bandwidth to improve ones life and enjoy small bits of it. What is wrong with that? If one goes to therapy with the expectation of becoming a complete different person they’d be sorely dissapointed.

Therapy can solve other issues too but one should first accept who they are

That's not anything to keep in mind at all. There are many different kinds of therapies and therapists. Lumping them together and writing them off is brutal and insensitive.

People need help understanding how to live. Therapists are trained to do that. Some of them are good at it, and some are bad at it.

But telling someone who is in need of structured introspection and practical cognitive and behavioral techniques to NOT go to a therapist is really pretty horrible.

Yes. I turned my life around at 43. Single, obsolete tech skills, lots of debt, personal issues. Began with taking a genuine inventory of my life and how I function, not just how I felt. I picked a constructive and structured approach to that, which looked a lot like CBT therapy but was something else.

It was a life reset, clearing out all the baggage. It was very difficult but incremental and genuine over time.

After the personal part, I levelled up my tech with some commercial online courses. When I began the career pivot, there was a lot of ageism and ghosting. Eventually I got a foothold and was on my way.

As for the family and relationships, I can tell you that I got a lot of attention from women once I made all those changes. There are so many looking for someone who is at least trying to handle their lives. I hear it all the time. Even being older, I get curious early 30s women who want families.

Now in my early 50s, my life is so much better. In no way do I feel my best days are behind me.

I'm 52. My life was a total mess, and I'm talking messed up relationships with my family, smoking like a chimney, debts, drinking and more . I cannot agree more that it is not the destination that gets you out of it, it's the courage to start the journey. Once you face the realities, deeply own them, and then genuinely change your day-to-day behaviour, things miraculously start happening even before you've cleared out all the problems. IE: your point about someone showing genuine honesty and courage in trying to get a grip on their lives. People really respond to that.

Personally, I'm lucky that throughout the above, I did keep up on technology. But another discipline I had to learn was not to give into my natural curiosity to try to learn everything that was interesting to me (Ocaml, Vulkan, Elixir, Yggdrasil Network, Rust, IOT, Matrix Protocol, Blender etc etc etc) all at the same time, but to stick to one or two and really persevere on them (I chose Rust). IE stop dreaming and giving in to curiosity, and learn one or two hard skills really well. T-shaped skills basically. No reason not to stay curious - helps you decide on the next vertical bar in the T. But don't waste too much time on breadth - also focus on depth so that at your later age, you'll still feel high confidence in yourself in this area even against the younger guns.

> IE stop dreaming and giving in to curiosity, and learn one or two hard skills really well. T-shaped skills basically. No reason not to stay curious - helps you decide on the next vertical bar in the T. But don't waste too much time on breadth - also focus on depth so that at your later age, you'll still feel high confidence in yourself in this area even against the younger guns.

This is exactly it. Finding something on which you can speak with authority is extremely valuable. Every third graduate coming out of university has been taught to sound confident from day 1. You can provide substance.

The part about attention from women is very, very true.

Obviously relationships are hardly the only thing that matters in life, but it amazes me how much more attention I get from women since I got my life together. Turns out a man who's figured things out and is doing reasonably well is very attractive.

The eyes never lie. Neither does body language; posture, tone of voice, conversational flow. All of those things change for the better when a person is genuinely content and secure with who and what they are.

I think for me, the hardest part is reconciling two things: 1) maybe being _too content_ or satisfied with life's mundanity — the idea of being settled down and spending most of my free time at home with my dog, playing video games, reading news, watching interesting videos, and occasionally reading a good book — with the occasional social gathering with friends, whether that's hosting a small party, or going to a fun local festival or event, and 2) finding a woman who is okay with what could be considered a relatively "boring" lifestyle. Most I end up meeting and dating are stir-crazy, I find later.

I obviously enjoy getting out of the house, but it's seldom. I go on hikes, explore local events a small few times a year, and play in a recreational volleyball league once or twice per year in seasons.

Despite all of this, I once had a woman tell me she "doesn't want to live on the couch" in response to my overall sedentary lifestyle. That's completely valid of her to think that, but I for one don't mind how much time I spend at home engaging with mostly solitary hobbies while I'm not working. I'm also pretty stubborn and unmotivated despite my overall contentment and satisfaction with life.

I want to find a wife who is content with a mostly simple, settled life with a little adventure sprinkled in between, but not so much I start to feel home sick, and it doesn't take much. XD

This is me, this is me. Ahah. But, I'm not sure I'm looking for a wife though. it is draining having a partner/relationship for me. After a while, I just go silent and kinda avoid communication. I'm in my 30s, sometime I'm scared to be old and alone. I can't make my mind up. The fact is that I mostly like doing my hobbies alone. This makes difficult for me to have companionship. Even eating, I prefer to do it alone.

May I ask your age bracket?

Ah yes! Sorry, I should have mentioned that. I am in my early 30's, dated a few women in my late 20's after a long break from dating, and was ultimately not successful. I am reasonably attractive/average, and can strike up a fun conversation, though I struggle with my longer-term relationships because I don't often have a lot new to share in life, and I love listening to other people's lives, as much as they're willing to share. I can always ask great follow-up questions and keep the conversation going smoothly — but I mention all this because it's certainly a core insecurity I have, that people may think I am not sharing enough with them because my life is so simple, and my interests are niche enough that I feel rude boring people to death about programming and gaming. Outside of that, I love politics, but that's a tricky topic.

I can relate a lot with what you said. I think deep down, I have a sincere desire to be married and (maybe) have children. The children part feels draining to me just thinking about it because I cherish my alone time and hobbies SO much. I know if I meet someone who respects my hobbies and alone time without any drama around it, that woman and I would be a very happy couple.

I'm with you though: I mostly prefer to engage with what I love doing alone, including eating. I will go out to eat with friends on occasion, or cook a tasty meal for friends hanging out at my house, but I generally have the luxury of solitude. One of by biggest fears is being bound to a regular interval of social activity, so if anyone ever tells me "We should do thing X or Y every Tuesday!", I panic, and soften the request with: "I may not be able to every week, but I'd love to from time to time. Let's figure out a day that works next week!" and go from there. Nobody is entitled to your time that regularly, especially as we get older and more committed to our responsibilities.

Finally I'll say, if you do decide to "get into the game" again with dating, just be upfront with whomever your partner is about your habits and preferences. It's hard not to feel like an asshole about it, but there are tactful, kind ways to strike compromise and understanding with those you love. When communicated as a deep need of your own, rather than an indictment against their social wishes, it can go a long way. Not everyone will agree or be amenable to that, but they also don't exist to shape your calendar or lifestyle. Another tip for early relationships, if you find there is tension around how much time you spend together, saying something like: "You know, I love spending time with you, but it's going to take some time for me to adjust to dating again. I've spent the last 10-20 years of my life comfortable being alone and chasing after my life without a partner this whole time. Thanks for being patient with me as we both adjust to this awesome new relationship!"

It's okay to expect others to adapt to your relatively non-intrusive ways of living. On the flip side, if you desire companionship with others, and thusly, a romantic relationship, some compromise will be necessary, but having secure, level-headed conversations about this with people is 100% the key. The empathy will flow both ways. I recommend reading "Attached" by Amir Levine for more insight on secure conversations with anxious or avoidant people.

"I just really need (and enjoy) being alone or being able to enjoy my interests without others interacting with me a lot of the time, and I know you love hanging out doing X and Y, and I love spending time with you whenever we're both feeling it, so let's play it by ear!"

Anyway, thanks for reading my novel. I hope this helps. It's encouraging to meet another person who feels the struggle between contentedness in solitude and our need for relationship.

I guess it makes sense that the best outward facing thing is a minimum viable working thing. All said with all the things that one can't see in others, in mind.

We can’t control if we find the right person - so control the things we can. Creating that confidence leads to a more confident exterior which is attractive to others!

Thanks for sharing that for the OP. The narratives we create in our minds to explain the world can be a huge source of suffering and act as giant barriers to any improvements we can make. “It’s too late because of X.” “The best years are behind me since I reached 40.” etc. I know this from experience in battling my own demons. Therapy can be a huge help here if OP can find the right therapist.

What commercial classes did you take to level up? Were they Coursera, Udacity or university classes?

I was trying to learn bankable React, but ended up learning much more. Udacity for the first Typescript and React courses, but they weren't made very well. I started (gasp) reading the documentation for many libraries and followed a few rabbit holes. A couple of months completing official tutorials I got lost and frustrated.

What put me over the top was a Frontend Masters subscription. By far the best value and flat monthly rate for all. Superior video courses for React/Typescript, but also advanced courses lower in the stack for Node, MongoDb, and an advanced javascript course. They have others I want to go back to, like web audio. I also took the dev interview and algorithm testing courses, which were super helpful.

Great outlook. This is literally true though with modern medicine and standard of living at many countries.

If you take care of yourself, stay fit, fix your brain life only gets better. If you're a pissed off 25 year who can't get laid on a constant basis vs a contend 50 year old who has sorted their life, I'd take the latter any day of the week.

Getting some sort of employment should be the first step. Work fills a large part of one's waking hours and is beneficial insofar as having some structure in life is concerned. Even if it is somewhat beneath your ability, having a job that helps you fill your days and get a small sense of accomplishment will do much more than any therapy or introspection will, all things considered.

If you are gainfully employed, you will find that your social circle will also start coalescing around you, and some benefits will follow.

Once you are employed, you can consider therapy. Do not neglect dating or forming romantic attachments either. It is much harder at age 43 but not impossible if you keep expectations in check. But I do not think therapy in the absence of basics is of much use.

If you have a job, you can use money from the job to visit the US (assuming you have a visa or can obtain one), and get a taste of the life you miss for a few weeks every year.

I don't have any idea why you think "a wife, kids" are out of the picture for you: after early adulthood, men and women are looking for someone they can see having a family with, and not for the more superfluous things in life (good looks, status or lots of money). At 43, having kids is harder for women, but usually not for men (well, at least making babies: bringing up kids does get a bit harder as you age regardless of the gender).

In any case, getting a job in a place where you'd be happy should "restart" your life: job is also a means to a new social life where you make the break from the old. So it sounds like you are only a decent job away from starting on the right path.

Having some vices also allows you to connect with others, so perhaps pick up a few non-damaging ones :D

Finally, note that you should look for professional help instead of listening to any of the advice I might give, though finding a psychologist who you can connect to is sometimes an ordeal as well.

> At 43, having kids is harder for women, but usually not for men (well, at least making babies: bringing up kids does get a bit harder as you age regardless of the gender).

And regardless, do consider adoption, even as a single parent. There are loads of kids taken away from parents who for whatever reason can't really care for them. Often there's a generational component: the kid's grandparent abused or couldn't support the parent; the parent ended up in foster care, exited out of the system at 18 with no support network, got pregnant, and can't really support the child. If they're not placed with an adoptive family, they spend the rest of their lives in foster care and repeat the cycle. You can make a world of difference.

My first marriage took a long time to resolve itself; by the time I married again, and we figured out that we were having fertility problems, my wife was "over the cliff" fertility-wise. We adopted a little one and he's been a real joy. You are wired to connect with children, and children are wired to connect with you; those circuits in your brain can't read DNA.

Obviously you need to get your own life sorted out first: lack of work and depression feeding into each other are major contributing factors to the problems the kids' biological parents have taking care of them. But get your head in the right space, a good support network around you, and a steady income, and there's no reason you can't be welcome a child into your family. Obviously having a partner can make the burden easier, but there were plenty of single-parent adopters in the "cohort" going through the adoption process with us. It's definitely do-able.

I second this! Had two bios, they got grown (as happens). Wife and I missing kids and fostered a little 5 month old girl and after two years adopted. She's 5 now and wife/myself are early 50's and she is the center of our universe and so much fun. We all fall asleep around 8pm :)

OP - You are young! Not even 1/2 way through life. You can do it.

Thank you for sharing this anecdote. It brightened my day. God bless you and your wife, and your daughter!

Be cautious with this. Lots of kids need adopting no doubt. But adoption can be extraordinarily difficult for parents. I speak from experience. It's not something to be taken lightly.

Raising children in general is not something to be taken lightly.

That, I wanted to mention this myself. E.g. adopting kids that are already in school. That'll make their day and also considering today's divorce rates they'd probably be already studying should a divorce ever happen. I know families that adopted kids and everyone did really well (and did not divorce from what I heard anyway)

> And regardless, do consider adoption, even as a single parent.

I am struggling to think of any official agency which would pair a child with a single man. Is this really something that happens?

Additionally, there are many single women with kids, which also will be happy to restore semi-normal family and find life long partner.

> At 43, having kids is harder for women, but usually not for men

Finding a partner becomes hard, especially if you expect her to be 5-10 years younger.

I used to be rather successful with women, was never single, always could find someone easily. I'm 45, in good shape with a good job, but it has became much harder.

> rather successful with women, was never single, always could find someone easily

The good news for GP is I think for a lot of people what you consider to be much harder is just the norm.

Totally agree with this. I have an older (late 50's) gay friend who considers himself 'over the hill'. He talks constantly about how hard it is to find someone etc. However, by comparison to myself and my other straight friends, it's trivially easy for him to find both sex and companionship. Essentially it was so easy when he was young and handsome, he learned an aversion to trying. It's not so much that he doesn't know how, it's that he feels he shouldn't have to. As an average looking straight guy, I find his entitlement absurd.

Same goes for OP. I'm literally his age, don't own property, have less in savings (I don't work in tech), and consider myself both lucky and free. Also lucky not to live in the US, where other people's perceptions of your relative wealth seems much more important for dating / social life etc.

Perspective governs so much of how meaningful and rich our lives seem. I look at my family / contemporaries who have children, or have crushed themselves at a desk for twenty years and feel inestimable gratitude I didn't sacrifice my life on that alter. OP's problem is a long period unemployment and depression, not some kind of nebulous 'failure'. Fortunately it's readily fixable. 43 is not remotely 'past it'.

> Essentially it was so easy when he was young and handsome, he learned an aversion to trying

I think a lot of women experience the same upon reaching middle age. In their 20s and early 30s, getting a date, sex, long-term relationship, etc. was as easy as firing up the app and letting a dozen men dance like monkeys for the chance to take her out.

By late 30s, this dynamic is gone for most women, and even starts reversing itself where by 40's, many men - and not just the "alphas" or gay men who also had an easy time in their younger years - have a lot more power in the dating market, though mostly because they aren't so beholden to their hormones, and can make decisions based on what benefits a particular women and relationship brings to his life. In most cases, the negatives outweigh the positives, and thus women and gay men now get to experience the same odds that most men dealt with all their life.

If you'll excuse me saying -- and I may be totally misreading your comment -- it sounds like what you were looking for (and finding) so easily in the past wasn't really a partner, at least in the life-long sense, but rather a string of casual relationships. That's not at all the same thing as wanting a wife and kids.

Not really, I had many long term relationships, and shorter ones in between. I wasn't a super popular man, but attractive enough that I could always find partners with reasonable efforts.

But in any case, I think it's not that different as wanting a wife and kids. You need to be able to seduce someone, whether it's for a casual relationship, or for marriage. It's start with physical attraction either way. I don't think mentioning "I want to get married and have kids" will give you a free pass which is ironic considering many women complain men only want casual relationships.

Modern dating where people meet online makes it harder too. A gay friend of mine who is 60 years old says that back in the day, he would meet guys in saunas or bars, and older guy would have a chance. But online, nobody want to meet a 60 years old guy.

How long term can they have been if you had “many” of them?

There’s a huge difference between seducing someone for a casual relationship and forging a deep friendship with the person who becomes your life partner.

> I want to get married and have kids"

I think this just comes off as moving too quickly. After a few weeks of successful dates and comfort levels built, I've found this to be acceptable to mention casually, especially in a conversation meant for discussing goals.

It also softens things to say it like "Yea, someday I want to be married and have kids" but in a tone that doesn't include the woman you're dating yet.

They already know you're dating them presumably for this goal if you mention it, but it also communicates you aren't desperate and already thinking this far ahead with this person (even though you probably already are).

> I used to be rather successful with women, was never single, always could find someone easily. I'm 45, in good shape with a good job, but it has became much harder.

You're also most likely much more selective. In your 20's and 30's, there's no feeling of a clock ticking.

Yeah, as weird as it sounds, my wife and I are probably together now 14 years after we met because we had relatively low standards in our early 20s. Obviously you should have some baselines for fundamental character traits when considering a long-term partner, but we were both well-intentioned-but-half-developed at 21. If either one of us had been in a position to look down on our relatively lackluster lifestyles at that point, we probably wouldn't be happily married today.

I guess my point is prioritize fundamental character (honesty, communication, loyalty, values, etc), and someone you can have fun with. The rest can be taken care of with time and effort.

I recently started taking dancing lessons, bachata, surprised by the amount of single women looking for a dance partner...

Also, men can circumvent fertility issues by dating younger. I know two 40+ men who started families with 20+ women, and so far so good.

Starting a family with twenty spouses sounds like a lot of work, honestly.

Reminds me of chain marriages in The Moon is a Harsh Mistress

I agree that starting a family is very much still a possibility but also would suggest that it doesn't have part of a solution. Marriage and kids bring their own challenges and make any turn-around much harder.

I think solving your personal issues and the job should come first.

Second that age thing, 43 is not 'too old' for a man, past prime yes but definitely doable if your health is OK in that area. As a person who has 2 young kids (first when 39, second at 41) - in some regards I am much better parent than younger me, the only problem that probably got worse with age (for me) is patience. But parents are required to have endless amount of patience anyway and I've seen even otherwise stellar parents to lose it more than once when pushed enough. If you don't feel up to it anymore, look for single moms and give some proper good into the world, it desperately needs it now more than ever. Don't let (often ancient) social norms of your specific place rule your life, science is on your side.

Tons of other good advices here - if you think you really are suicidal (and not just fleeting emotion in the lowest position), get professional help, even if it means moving away. You owe to yourself as much as to anybody else, including your closest family. Otherwise try to get a job you want and like, AND get into some sports, whatever it is. Being active brutally increases mood, happiness and often integrates you with like-minded people. On top of usual stuff like better sleep, sex, longer better life overall etc.

Do some 'charity' work, helping unknown people with whatever, its extremely rewarding. Attempt in some way to overcome procrastination, attack it from different angles, ie set up appointments that you would feel ashamed to cancel later.

Second that.

I wish people would avoid not rejecting "it's too late for kids at 43".

The more implicit affirmation you hear on HN it strengthens that false belief.

I am 42, single, similar situation. I was in a pretty dark place around 38 or so. I happened to read "man's search for meaning" by victor frankl and it honestly helped A LOT. When we are young and nature is working for our benefit, we should search for happiness. Beyond that, we need to search for meaning.

There are 2 meanings implicit and third one you can pursue. 1) Search for meaning is meaningful itself.

2) Human life has intrinsic meaning. I dont agree with nihilism that life has no meaning. Life has no 'given' meaning - correct. But since we are conscious, there is a living being going through experiences, there is intrinsic meaning to human life. Consciousness gives meaning to everything. In absence of consciousness, nothing has meaning. This intrinsic meaning is irrespective of life success. Even for a complete failure, since a real living being went through this life, the life still has meaning.

3) External meaning. This is related to success happiness relationships helping others etc. This is a bit fragile, since if you lose these things then you lose meaning. And if you are not successful, life might feel meaningless.

A healthy life is a balance of pursuing external meaning and accepting and giving value to internal meaning.

It is not happiness vs meaning. happiness is one of the things that gives meaning to human life.

Wish you all the best.

Another bit of recommended reading is The Myth of Sisyphus by Albert Camus.

I had read Frankl years prior, and while he helped me thoroughly understand the concept of meaning and the immense value of it, he didn't help me find it when I needed it. All of his suggested paths felt a bit wishful or self-deceptive. Absurdism was the only conversation that felt like it was grappling with the problem directly and unadorned.

There are many answers to what is the meaning of life. Lacking some important aspects of life like family, career, etc. because of past decisions, or losing someone dear may put anyone in a situation where they question the very meaning of life and even when things are all fine we look for a purpose to make sense of things around us. Some philosophers look at this question and argue for passion, some inner peace. Frankl says one needs to seek their own meaning of life. Find whatever it is, make it meaningful for you and hold on to it.

If you are in a dark place do yourself a solid and try reading Frankl's book mentioned by OP. Reading about Montaigne's life (there's a recent bio book about him) may also help. Seneca's or Marcus Aurelius's writings will also help when it particularly comes to the issue of how worrying too much about things we can't control affects us. Every living breathing soul has their own demons and issues with life, you have yours so most importantly go easy on yourself.

No a psychiatrist is. Stop wasting people's time and put them in more danger than they already are.

Speaking as someone who has done both, you are wrong, it's a great place to start

> Life has no 'given' meaning

Careful [0].

The conclusion that life is meaningless as such is what follows from materialism by necessity. What is often unappreciated is that bad metaphysics leads to bad ideas, in this case that life is meaningless. And why is materialism at fault? Because it denies telos. Without telos, life is, indeed and quite literally, meaningless. But why should that trouble us if we, the world, all of it, were as the materialists say it is? Needs don't exist in a materialist universe because need implies telos (a need is always for the sake of something), and we suffer when needs aren't met, so where is this suffering about there not being any meaning in the first place coming from? So clearly, telos is real and materialism is, for this and other reasons, wrong. Otherwise, it makes no difference how you live, or even whether you live or die. Why should it bother you? It's all meaningless!

Another source of "meaninglessness" is moral in nature, specifically, that somewhere in our lives we pridefully rejected meaning because it opposed something illicit we wanted to do. Telos is the basis of morality, after all. This is something Aldous Huxley has written about. To quote him[1]:

“I had motives for not wanting the world to have a meaning; and consequently assumed that it had none, and was able without any difficulty to find satisfying reasons for this assumption. The philosopher who finds no meaning in the world is not concerned exclusively with a problem in pure metaphysics. He is also concerned to prove that there is no valid reason why he personally should not do as he wants to do. For myself, as no doubt for most of my friends, the philosophy of meaninglessness was essentially an instrument of liberation from a certain system of morality. We objected to the morality because it interfered with our sexual freedom. The supporters of this system claimed that it embodied the meaning - the Christian meaning, they insisted - of the world. There was one admirably simple method of confuting these people and justifying ourselves in our erotic revolt: we would deny that the world had any meaning whatever.”

Now, this sort of stuff about "consciousness" is like an existentialist opiate that temporarily soothes the pain of half-baked nihilism, but it is fragile b/c it is incoherent. Everything is meaningless, but I can invent meaning ex nihilo b/c "consciousness"? It sounds like we've quietly retreated from materialism into some kind of strange dualism where everything is meaningless but somehow "consciousness" is now pregnant with meaning. This may be the cunning of reason, leading us back slowly to the telos of human nature through a series of metaphysical halfway houses.

That's the theory. Practically speaking, people say one thing, but implicitly mean something else (materialists don't believe materialism with any real integrity because it is impossible). So when you say that "consciousness" gives meaning, you may in practice simply mean "This is the meaning I perceive" which may very well be the objective meaning. Or, it could be a way of maintaining one's refusal to conform to objective meaning and therefore objective moral duties by retreating into the virtual reality of subjectivism (this never ends well).

> happiness is one of the things that gives meaning to human life.

This is exactly backwards. Happiness is the result of satisfying the end(s) of human nature. Happiness is teleological and therefore presupposes meaning, not the other way around.

Of course, we are not guaranteed complete happiness in this life, but Kant, in a stoically severe bit of insight, said we nonetheless ought to strive to be deserving of happiness. This is the life of virtue.

[0] https://thomism.wordpress.com/2022/12/07/meaning-simpliciter...

[1] https://www.goodreads.com/quotes/465563-i-had-motives-for-no...

Not me, but my Mother indeed turned her life in a completely different direction in her 40's. Up until then, she was married to a verbally abusive narcissist for 20 years (my father–a decent man and excellent surgeon, but with unaddressed mental health issues). She and my Dad divorced at 40, and she returned to school to get the degree she always wanted. She completed PhD in English Literature and, for the last 20+ years, has been an accomplished English professor and author–writing everything from illustrated children's stories to graduate-level textbooks. She also met another man, and they've now been married longer than she and my father.

Your perspective is out of calibration. You're halfway through your life (ish). Your best days could easily be ahead of you. You need a therapist, and they are available online. Doesn't have to be one in your town. My wife and I have seen a couple's therapist online for 3+ years now, and it's an excellent way to spend our time and money.

Life is hard. It was hard then and it will be hard now, but you can do the things you want. And the second half is coming whether you do them or not, so you may as well get started.

My Mother turned her whole (entire) life around at 55. It has been remarkable to watch, and it was pretty dark before this period of time. It's possible.

No offense to the reply, but “need a therapist” is a very American response and a bit of a cop out.

OP, I’ve seen many people turn around after aged 40, including a friend who got married for the first time at aged 58. She’s energetic and attractive and incidentally also turned her life around after 40.

My two pennies would suggest you throw the past expectations out the window, determine where your passions lie, and set short-term intentions / goals. I might also suggest looking to groups where people are successful but take approaches outside the norm. My friend for example is a successful physician and involved in a Yoga community that is global and inexpensive and where he can meet others of like kind. Build community for yourself.

THANK YOU

I know "see a therapist" is generally meant well, and therapy can definitely help, but people are way too quick to suggest it, and suggest it as a must. It can communicate that a person is broken when their situation can be due to any number of things besides brokenness. I think most people know that therapy is an option, and I think many also underestimate the difficulty in not only finding an adequate therapist but a therapist at all in any reasonable amount of time.

"See a Therapist" being the first, top-voted comment is to me a sign of a sick society, where loneliness reigns. In a world where in middle-age your closest friends are married with kids, and most people prefer to be 'remote-first' in friendships (you chat online with even friends you know), the answer "see a therapist" is for most people instead just a proxy for the gap: the gap of close friends and family to be able to bounce ideas and feelings off of.

What should see a therapist is society itself, with top answers like that. Therapy should be reserved for the eccentric pathologies, not for routine middle-age crises and life situations.

You hit the nail on the head, but it's too late for that now, therapy is the new trend and will only keep growing from here.

I went through quite a bad phase...I started having mental-health problems, this triggered changes in my life that made everything worse, causing more problems, spiral.

I have been through three course of therapy, they helped me understand what was happening when I had an episode but...I was still in the same place, and that made all my mental-health problems worse (this isn't a post about that...but everything changed when one aspect of my material situation changed...when you go through this, everyone who has never had a problem like this will tell you therapy will help...maybe it will but your material situation is more important...there is no-one selling "material situations" at $200/hour though, so that tends to be emphasized less). No-one wants to acknowledge this because it makes mental health a trickier problem to solve.

I will say generally too: putting yourself in a situation where you are constantly looking for "the answer" is fundamentally unhelpful. You may not be able to overcome it yourself, but that doesn't mean a therapist can help.

Whatever man. Nobody is implying that therapy means you are broken. It’s about growth and self actualization.

Lots of people use "therapy" for performance optimization for example: sports psychology.

I agree 100%. It can help some people, but it's not a panacea. I have known people that went to therapists for years and didn't really make any progress. And some people arguably get worse. For example, what's the benefit of a therapist that gives you the illusion of making progress and you stay in a poor relationship longer than you otherwise would. That actually happened to someone I know. They stayed in a relationship for years trying to "fix" things. Then within a year they left their crappy situation, met someone way better, and is happier than ever. Be careful with seeing a therapist. And be very careful recommending them to people. I think a lot of people doing the recommending don't actually have first hand experience with it.

It's easy to find a therapist. It's much harder to find the right therapist for you.

Its better than the OP seeks help from someone trained in this domain rather than getting an anecdotal therapy session from these comments.

Getting professional help shouldn't be stigmatized as a cop out.

Agree 100%. One needs help for sure, but help doesn't mean therapist. It's someone who cares, parents / sibling / spouse / cousins some family or close friends who truly care. Don't be alone

> No offense to the reply, but “need a therapist” is a very American response and a bit of a cop out.

I'd change it to "need a psychiatrist".

I don’t follow your last sentence.

Why? Because it is a very American approach that is less the norm elsewhere. Therapy is not an industry to such a degree necessarily in other countries. Cop-out because it is akin to RTFM, ‘go Google it’, ‘delete and re-install’. If one doesn’t have a personal viewpoint, why bother responding.

Psychiatrists differ from therapists in the US because they can prescribe meds. Antidepressants, ADHD meds, etc. Not sure what his point is though.

I understand your frustration with the "go to therapy" response. Even in the US there is a dismissive undertone to comments like this. The reality is that the people who get the most out of therapy already have a positive outlook on its benefits.

Therapy doesn't fix anyone directly -- it gives a people a vehicle to look for ways to fix themselves by talking to a non-judgmental arbiter. People that have already done that tend to take it for granted and obviously there's a ton of variance in results/quality of therapeutic conversation.

Eh I don't think a random non-judgemental arbiter would have the same efficacy. Therapy also usually involves teaching specific tools for dealing with negative thoughts. Parts of that could be outsourced to a workbook, but at times there is helpful personalization that occurs.

It's totally true that it requires some buy-in, but so does an exercise routine. Things that require effort require buy-in.

It is also true that there's a ton of variance and that some people who give it an honest try still don't really improve. This stuff is still really poorly understood for the most part, and I don't think therapy is a silver bullet. Neither is anything else anyone suggests.

So yeah therapy is far from perfect, but I think it's selling it a bit short to suggest that the entire effect boils down to a facilitated self-conversation.

I also don't get why others are so annoyed by the therapy suggestion, as I don't really see the downside of trying it. OP should look into all the options he might have, which IMO is the point of seeking community advice. You're not going to get an exact answer from HN comments, just some ideas.

Not the original poster, but regarding the last sentence, a psychiatrist is a medical doctor who can prescribe medication.

A medical doctor can evaluate the OP much better than we can, and determine if medication may be able to help, in addition to changing thinking patterns.

What? No it's like format whatever that shit is and install Ubuntu.

Still not following, but I think that is a function of the medium.

I think the US therapist industry is a symptom of its culture and relative lack of community. There is an important role for mental health professionals, don’t get me wrong. I’m referring more to the industry of mental health.

What other countries are you thinking about? Certainly in other nations with higher degrees of religiosity and intact community, people may share their issues with clerical figures.

Certainly the American mental health industry, especially the pharmaceutical component, is skewed by all sorts of misaligned incentives. But I doubt that Europeans, Canadians, or Australians are not taking advantage of therapy options offered by national health systems.

First, way to go! You've chosen to be vulnerable, and that is a great first step.

Second, get a therapist. It may seem expensive, and not helpful at first, but as I'm sure you already felt in writing this post, just talking about your thoughts and issues really does help.

Third, it's NEVER too late. I'm 42 and learning and growing daily. I've had to change a lot in the last decade to remain 1) relevant, and 2) in the loop.

I've had to learn to network again, because my original network of friends and colleagues dried up. It's possible, and after you start with a therapist, it'll be easier and more rewarding than ever before.

Finally, and I can't stress this enough, get out and do service for others. Soup kitchens, shoveling snow, cutting grass, whatever you can do. It will give you an immediate jolt of worth, and make the world a better place for all involved.

I wish you luck friend. If you need more talking, let me know utahcon [at] utahcon dot com

Hey brother hang in there. My grandpa didn’t have his first kid until he was 68!! And his wife was in her young 20s. And they were in love till the day he died in his late 80s. He wasn’t any kind of programmer or rich or anything. It’s an atypical story but the point is do not EVER think the best of your life is BEHIND you! One of the most foolish and important of all emotions is hope. Hope is about taking a look at the data and realizing that the situation is grim but choosing to proceed as if life has good things in store for you anyway. Beethoven’s 9th symphony was written when he was stone cold deaf and he wouldn’t ever get to hear a single note of the music, and yet he wrote it anyway as a big middle finger to the cruel hand that fate dealt him. If you look at his writings from the time, they were pretty dark. That’s why Ode to Joy brings me to tears darn near every time I hear it. Hope has a way of making its own luck, if you are open to the possibilities that life puts before you and you don’t hang onto the wheel too tightly. Last thing to remember is that YOUR story is beautiful, even the tragic parts, because it is your experience. None of us have any idea what we are “supposed” to be doing here. No one’s journey is more valuable than anyone else’s. And the sad parts of being human are part of the experience too. Hang in there man. There is so much beauty out there for you to discover, out there and within.

I sorted my life out in my mid-30s. Still divorced and single, which is scary as I push 40, but everything is on an unshakable upward track.

You are in a wonderful position, and a tough one. What's tougher than feeling sandbagged by your own psyche? What's better than not being an addict who's hurt everyone that matters to you? Well done having savings from over a decade ago, that is exceptional.

You are far from alone. Lots of people feel stuck, over the hill, like they have unique and unhelp-able problems.

Everyone else has already suggested getting a therapist; it's a real project to find the person (person, not school of thought) right for you, but worthwhile. If you can learn how to meditate (stick to the traditions imo), many people find therapy + meditation a great one-two punch combo. Maybe the best. A mushroom trip might help.

Thank you for the work you've already started, and best of luck.

So many responses already, I'll just add that if you desire a family it's not too late. I'd suggesting getting other parts of your life in order a bit first, but I know people who are getting into relationships and even marriages later in life (40s). Even children aren't entirely out of the question (although at this point they do tend to be older than infants). If it's really something you want in your life, don't think that it could never happen.

Here's a thought - through proactively seeking help by posting on HN, you just made it to the front page.

You got feedback from people across the world. Some highly skilled (and paid) people stopped what they are doing to help because they understand and want to help. There are a lot of people who want to help. Some have been where you are.

Most people on this thread are vastly more positive about your outlook than you are - some of them because of their personal experience. The only person who thinks you are completely stuck is you.

As many other people have said, even if everything else is too complex, you need to get a therapist. Use your savings if you have to. If it's not working, get another therapist until you find the right one. It will work.

> Here's a thought - through proactively seeking help by posting on HN, you just made it to the front page.

I thought your next sentence was going to be "now turn that into a startup idea to live happily thereafter".

there is a proverb around here...

"when the cart goes wheels up, ah, plenty of roads.."

it is mostly always taken the forward, negative way (like "too late when wheels go up").

But there is a backward, positive way. "if you want to have many roads... turn the cart wheels up." see Sacrifice by Andrei Tarkovsky.

But maybe not exactly your situation.. maybe the Zen idea of "when you name a thing, it's not the same thing anymore (for you)" might be better. That.. works also for negative things - name your fear somehow, and it's not fearfull anymore..

https://www.mindmate.org.uk/wp-content/uploads/2018/11/label...

stop looking back and comparing yourself to whoever. you can be great (fun) without being like everyone else. Find something to strive for. Anything. Go for it.

Bro you are are on the right forum. My family has a healthy dose of depression passed down. I can read it in every word you're writing. It's just a chemical reaction, you can defeat it but it will be tough.

Achievement cures depression. Any achievement. Dead time exacerbates depression - i.e. watching TV, playing mindless games, porn, hell even reading sometimes (if it's trash and you're just reading to escape your reality - obviously lots of reading can be good). Quit escaping your life because it's shitty or it will remain shitty.

So try this, set a small goal for yourself, either fitness or professional (i.e. a training course online, Udemy, etc. maybe refresh your BI skills with some modern Big Data type stuff). And just give that 100%. Knock it out, get the certificate, lose 10 pounds. Just one small win. BTW I work in that field a bit - it's gotten so much more fun in the last 10 years than just running Tableau over and over. Cloud services have made analytics just amazing.

Start there. The rest will come as you continue to set small goals and string wins together.

Don't worry about what happened already. Shit happened, now you just adapt and overcome.

Never quit.

I have a mild case of depression and I live by this, it has helped me tremendously. At the beginning it will be very hard to push yourself to start something new but after a couple of achievements you kind of get to anticipate the rewarding feeling at the end and it gets easier.

I'm 46, just recently got my self out of homelessness and addiction. Been clean and sober since June.

I've been studying programming/webDev for the past year (since my last release from prison) with the hope of making something of myself other than being a 46 yr old ex heroin addict, ex con, etc. Looks dim for me, oh well.

I'm in a similar situation as you (regarding depression. Esp. concerning certain thoughts of cashing it all in).

I just watched a movie the other night called Stutz, a documentary by Jonah Hill about his therapist. If you can get past the parts about Jonah talking about himself, the Dr has some really excellent gems of wisdom and advice in that film.

Keep your head up bro

> just recently got my self out of homelessness and addiction

That's huge! Congratulations, you should feel proud of making a positive change like that. Many, many people do not recover and don't make it. Many of them don't _want_ to.

Life is largely dictated by our pesky brain and how we view the world. 46 isn't _that_ old, you still have a ton of life ahead and if you view it from the lens of breaking free from your own personal prison, finally getting the opportunity to experience the fresh air of tranquility, you might just realize the future is indeed bright and not dim.

Good luck friend.

I don’t know you or what you’re going through but even though the above is true I would be saddened to know if you harmed yourself. Life is and can be tough. I’m posting the below not to try and play any game of “my problems are worse than yours”.

I’m currently in the midst of a fight with incurable cancer. There is a hope that they can shrink the numerous tumors and affected lymph nodes with chemo and I will have a risky surgeries shot at being cured. According to the very pessimistic internet my type of cancer across ages 8-80 means I have 2 years to live on average.

Funny thing is a few years ago I was a contractor and was billing up to 80 hours per week. I missed a lot of family interaction doing this and I now regret working so long.

So my point in all of this is health is literal wealth. And aside from needing to address your mental health (parents dying is not something you should just stuff down). It sounds like you are generally healthy but going through something. It may be tough to get through this phase of your life but if you do I’m pretty sure you will be happy you did.

Hey I am older than you. I just want to suggest that it's probably not a great idea to look at turning around your life as if it's binary.

What I would personally be looking for, if I were you, is an aspect of my life that I can turn around relatively easily, and then a second one, which might be a little more challenging.

Try to develop a little momentum in the direction that you want to go in life.

From there, I would keep breaking down the things that would represent a complete turn around for me, and try to achieve those things one at a time.

We all get on losing streaks in life. We all have technologies that we work with that go from hot, to good, to old, to unpopular. But I argue that we can't look at ourselves as a failure or success in a binary fashion.

We have to keep reinventing and course correcting, one step at a time.

Good luck!

There are magic bullets. But I feel a few months ago as if I stumbled upon one:

My regular sports team (ultimate frisbee) disbanded after the pandemic, so I found myself without any physical exercise. I thought I probably should go to the gym but realised I wasn't going to do it after work, and neither before breakfast. Also, I am 34 and have never visited a gym before in my life.

Then I found a gym across my office which specialises in High Intensity Interval Training. They are group trainings that only last 25 mins. Including overhead (shower, dressing, etc.) it takes 40 minutes. This means my lunch break is about 1h15 minutes long, but it includes sports!

It has transformed my wellbeing, and I feel suddenly I am acting on issues that I have been procrastinating on for years.

Obviously there are many other things you could/should do in your life. And the other comments here are very valuable. But maybe if you are only going to do 1 thing... Consider this. Or consider it several years down the line when other things have worked out :).

You sound like Joe Rogan: you have a problem, just workout man. It's not bad advice imo, just doesn't apply to everyone the same way.

It does seem that it applies to everyone in _some_ way, at least.

> They are group trainings that only last 25 mins.

For a good 20 years - from early teens through mid 30s - I began and eventually quit various workout and gym routines, memberships, etc because I couldn't find the time or because I would dread going so much I'd invent any excuse in my mind to avoid them.

My mistake was assuming I needed to go for an hour or more at a time, and also that I needed to do 20-30 minutes of cardio.

It wasn't until my mid 30s that I realized I wouldn't dread it so much if I limited my workouts to 20-30 minutes max, and that I didn't need cardio (which I despise) and instead could just do some compound free weights exercise - just 4 or 5 simple lifts. Maybe 2-3 sets of 5 every other day.

Since then, I enjoy going and have been consistent about it for years.

Just turned 47 this morning. I do have the kids, house, and accomplished most of the things I wanted to when I was a kid... but there's always more, there's always the things I haven't done, the things I have failed at, and the list goes on. I too feel the bitterness, anger, and disillusionment of the current state of the economy, my career, etc. I wonder how much of this is a product of those of us working in tech related/adjacent fields and the industries promises of the past few decades really not panning out. I feel like we're in an age of disillusionment for those of us who bought into those promises only to ... <<gestures broadly at the Internet>>.. see what has come of it.

I am never going to be rich, it is never going to be "easy", and while it could be worse it could be a lot fucking better too. And it is going to get harder before anything else changes.

What can you do about it? Fuck if I know. I can't deal with my own shit. But the one thing that has helped is trying to re-evaluate my current situation. Sometimes I feel locked into focusing on the things I can't have, the things I didn't accomplish, the mistakes I've made, and just have to accept that I cannot change them. I can only look at where I am now, take inventory, and try to re-orient myself. I've heard that works for others and it has helped me in the past, but it isn't a one-and-done exercise. Maybe I'm wrong but it has gotten me this far.

"You Are Not Alone" by Andrew WK (yeah, the Party guy) has been a fantastic cathartic resource for this middle aged dude in the 202Xs. I recommend a full listen -- end-to-end -- through on decent headphones and a place where you can safely process emotions. https://red.lnk.to/AWKYNA

Take care man, I hope you find a way to accept where you are, that you find peace, and make a plan for where you want to go next.

> I had all the desires of a regular guy: a wife, kids, a house, meaningful work, etc. I mean I still do, but I guess I'm too late for the first few.

No, 42 is not too late. You have to take care of somebody, this will fill your life with meaning. This meaning is hard to describe (it may not look rational), but you will feel it. Also, stop looking for a "meaningful job" - it's unlikely you will find one. As soon as you realize that the only thing that matters is taking care of your family, the issue of "meaningful job" will automatically lose its importance.