Hacker News Reader

Comment by shadowfaxRodeo | Hacker News Reader

I tried everything except for medication. I was afraid i would no longer be 'myself' or that's what other people told me — or maybe that it would make the problem more real.

Anyway, I eventually took meds, and I have never felt more myself, or the person I want to be. I work, learn, socialize, live in a (relatively) clean apartment, which I leave to go outside.

It took me way too long accept that depression is not all my fault, that it's a disease, and that I needed to see a real doctor.

For those who suffer, or know those who suffer (that's probably everyone) I really recommend this lecture:

https://www.youtube.com/watch?v=NOAgplgTxfc

It's super interesting, it ties all the causes of depression together — childhood trauma, everyday experience, down to the neuron, and chemical reactions. It really helps externalize it.

View on HN

Same here. Prozac and walking 30min a day building up to 50min a day changed my life. I eventually quit smoking a pack a day cigarette habit also. It took years for me to try SSRI though.

Not taking prozac was a combination of being stubborn but you also never really read anything good about SSRI. It doesn't fit the narrative that big pharma is evil.

I tried therapy but the therapist were honestly terrible. The only good one was the one that prescribed me Prozac but the actual discussions were basically nonsense.

SSRI get a bad name IMO because people want to take them and magically have all their problems solved that lead them to be depressed. IMO it has to be in combination with a real willingness to absolutely change your life and habits. Have to get in good physical condition. The idea you can sit around all day, getting more and more out of shape but somehow not be depressed is not really logical.

ADHD makes me feel like this. There's days where I wake up and I just can't cope with anything: everything feels like a chore to power through.

However, I don't like to medicate. I always feel like they tone down my personality and I'm just not energetic anymore. It's a real shame because the meds (atomoxetine, an SNRI) eliminate my anxiety.

I honestly try to power through the days. I find that having solid habits and a routine is a big help for days like this. It's a lot easier to get things done on a bad day when you don't have to think about things much: just wake up, do your bed, and start your morning routine.

Your post inspires me though, I might start taking the meds again. I dropped them for side effects and the aforementioned personality changes. I'm in a good place right now, but when the lows hit, it gets really annoying to constantly power through life on hard mode.

You can also try different meds if the ones you take have bad side effects

I should have mentioned in my comment, the first meds I took did absolutely nothing, it was the second try that actually did the trick. Worth giving it another shot.

Out of curiosity, which meds did you try?

With ADHD there are really only two options; atomoxetine (Strattera) and stimulants like aderall or ritalin (or any of the dozens of time-release versions of those two drugs).

I did stimulants for years and they really distorted my sense of self in a way that was hard to put a finger on until I got out of the long-term traumatic situation I was in. I felt like life was a treadmill and I was looking at my feet the whole time — I could go really fast but I lost sight of everything around me. I switched to atomoxetine and while it still takes effort to start something, it’s much easier for me to take a task to completion (or at least further towards completion).

Amantadine and certain antidepressants are said to help some people affected by AD(H)D as well. But talk to your doctor before you go "oh, amantadine is cheap otc flu med...". And it depends on a lot of factors, like your exact symptoms (with/without hyperactivity), treatment goals, side effects and secondary problems. Really really talk to a doctor about this, getting "the meds" right is complicated and takes some trial and error.

Wikipedia says guanfacine and clonidine too. And bupropion and modafinil off label.

Citalopram then Sertraline.

Different people have different reactions. This is not medial advice. Consult your physician to see if sertraline is right for you.

This is what stops me. I definitely have at least societally caused ADD (i.e. internet is just a click away full of ways to waste the time away), but probably a bit more than that, and I have a close family member with diagnosed ADHD, so I probably could get it diagnosed and get meds for it...but I'm a little afraid I'll lose one of the good things about it, which is my brain keeps bouncing around from idea to idea and comes up with all sorts of interesting things.

Now being able to stay focused to get those finished enough to get them out the door and released on the world is another thing entirely, and I seem to be having more difficulty with that now that I'm older and have more natural distractions such as two dogs that always want my attention at the worst times :)

But yeah, always had issues with deadlines, getting to places on time, impulse control, focusing on things I don't care enough about (i.e. work), etc. I've muddled through anyway and done alright for myself, at least so far, but I might get more accomplished with some medication.

But then what if I stop coming up with cool game designs and stories and music as a result?

The other thing that stops me is that close family member had some bad reactions to ADHD meds (both physical and mental), so that also gives me pause, since we share a lot of the same genes.

> But then what if I stop coming up with cool game designs and stories and music as a result?

It seems to me that you could try it, and if you don't like the results, then stop taking it. The effects aren't permanent.

Yep. I tried Adderall and the effects weren't quite what I wanted, so I just told my doc and tapered off it.

(I had trouble sleeping, and it wasn't giving me executive function in the evening when I needed it to, instead I was crashing after work)

They were permanent in my family member's case. They're not taking the meds anymore (taking anti-psychotic meds now), but they're still getting worse. Granted they did take it for several years before it became apparent (and/or they let others know) that this had started happening.

Not saying the meds are definitely the cause, maybe it was a latent thing they always had, but we share enough genes I'm not sure I want to take the chance. The effects it had on them was/continues to be pretty scary.

https://www.healthline.com/health/adhd/adderall-psychosis

This is probably my main concern, actually, not so much the other, sorry for not making that clear.

There are other medications that work differently.

> But then what if I stop coming up with cool game designs and stories and music as a result?

Do you come up with the designs and stories and actually implement them or are they all half-finished projects? I think if you’re actually completing them, there’s no need to change and I somewhat doubt you have ADHD.

If they are all sitting half-finished on the shelf, yea that’s different. IMO

Almost all half finished, especially lately (pandemic really killed a lot of my creative drive and seemed to make my mind even harder to focus). I’ve got like 50 board game prototypes and zero published (1 signed with a publisher though, and a couple that have been finalists in design contests though, so maybe someday), eight novel manuscripts I could never finish editing (most written during Nanowrimo), six half-finished video games (8 finished and released ones in my past, but zero in the past…almost 10 years now), etc.

I feel you there. Especially with the creativity stuff.

My girlfriend mentions that her ADHD meds (Concerta, or an off-license / cheaper alternative with the same active ingredients and slow release) act as a mood stabilizer more than anything. She's struggled with depression for ages, antidepressants or anything changing her hormones made her spiral downwards instead of make her feel better.

One thing to keep in mind is that it takes a few days for it to be fully effective (leftovers from the day before overlapping with the next dosage). Another thing is that if it doesn't seem to do anything, you may need a different dosage.

Another colleague diagnosed as an adult described the effect to be quite mind-blowing, as in, his head finally quieted down.

Anyway, nobody I know mentioned they feel like they are someone else. It helps them function and cope with daily life. The "ritalin changed my child into a mindless zombie" memes are over the top, or may imply they've been vastly over-medicated (although ritalin is short-acting, whereas concerta are slow release).

And finally, it's fine to take a medication break every once in a while, it does seem like you build up a tolerance to it.

> It's a lot easier to get things done on a bad day when you don't have to think about things much: just wake up, do your bed, and start your morning routine.

The routine stuff is the 'easiest' part in some ways. It's "not having fun" that can really create a drag over the long term:

> Anhedonia is a diverse array of deficits in hedonic function, including reduced motivation or ability to experience pleasure.[1] While earlier definitions emphasized the inability to experience pleasure, anhedonia is currently used by researchers to refer to reduced motivation, reduced anticipatory pleasure (wanting), reduced consummatory pleasure (liking), and deficits in reinforcement learning.[2][3][4]

* https://en.wikipedia.org/wiki/Anhedonia

In my experience, for an ADHD folk the routine stuff is the hardest.

If it doesn't give you a hit of dopamine, it becomes extremely difficult. Anything from homework to daily chores means your brain entering a deep brain fog, almost like a subdued headache.

Getting to a point where I have the discipline and self-control to maintain a daily routine has been a lifelong challenge.

> It's super interesting, it ties all the causes of depression together — childhood trauma, everyday experience, down to the neuron, and chemical reactions. It really helps externalize it.

I’ll need to check this out. I really want to know more about what depression “is” before attempting to treat it. I’m skeptical about most suggested treatment options including medication, despite me being least skeptical about that. However, I was many years ago diagnosed and thrown on medication. Hard to not be cynical when you’re watching TV a decade later and see ads for a class action lawsuit regarding long term side effects of a medication you’re on because the company fraudulently claimed it was safe.

If you don't mind sharing, what meds did you go on?

depression is not a disease, it's a name for a group of symptoms with wildly different causes and remedies.

Disease is a pretty vague term — perhaps there are situations where it has a more specific meaning but in general usage it just means "health condition"

Depression is used as an example of a disease in the first few paragraphs of the wikipedia entry for disease

https://en.wikipedia.org/wiki/Disease

Here's the Merriam Webster definition, I think depression fits into it.

https://www.merriam-webster.com/dictionary/disease

The issue with people I know who take them are more than not feeling oneself, it's potential side effects like sexual issues, weight gain, and for the creative types, feeling less creative (so perhaps more of the losing oneself fear).

Thank you so much. You changed my life.

Reply on news.ycombinator.com