6 ms·

I've been on medication for about a week now and I've not thought about offing myself once since starting. That seems dramatic but honestly that used to be the

by corobo 5y ago

I've been on medication for about a week now and I've not thought about offing myself once since starting. That seems dramatic but honestly that used to be the default go-to answer for any problem that couldn't be resolved within a day or so. Seems a bit excessive of a response to problems now.. It really looks like my depression might be rooted in undiagnosed ADHD. I can also if not properly focus on tasks at least force myself to finish whatever I'm working on before wandering off. I'm going to give it another week then ask for a bump on the dosage to see if that helps that one Negatives: Sweating a bunch, especially at night. Then again we are just about cruising into summer and in my old place I had aircon so that might be unrelated, but it is a possible side effect. Appetite seems to have taken a hit too. While I am fully for that (I could lose a bit of weight no bother) I will keep an eye on it Due to covid restrictions I've not been seen for talky therapy or anything yet, this is purely medicinal treatment currently but it's been a MASSIVE positive move for me

mial 5y ago
Medication helped a lot in the beginning, but what really helped in the long term was talk therapy, and setting up helpful systems and habits such as exercising, diet, journalling. But this would not have been possible without taking Ritalin in the first place. I'm mostly off-meds now.
- WhyNotHugo 5y ago
  I found the medication useful in interesting ways. While on its effect, I've learn what it feels like to be focused, how ones mind works when in "not easily distracted mode", and I've very slowly learnt to apply some of these things even then not taking the medication.
- lostmyoldone 5y ago
  This is a good point! Stimulants are not always necessary long term, but they usually are to start effecting enough change to be able to function in the present society. For some (me probably) it'll be a lifelong thing, but it definitely doesn't have to be for everyone! I'm happy for your success! I really wish I had access to more talk therapy, physiotherapy, guided relaxation, mindfullness'ish sessions, and some other forms of support. The medicine helps me to stay mostly functioning, but with talking to a therapist and practicing "basal body knowledge" I was feeling so much better!
- corobo 5y ago
  I'll be starting the talk therapy side of things soon I believe! Bit of a lag on that due to covid etc. I've already had some systems in place (if it's not in Todoist it's not getting done) but I was falling behind even my norm. If I can get to a point where I can function well enough without meds that will be brilliant, here's to hoping :)
richthegeek 5y ago
Definitely try some of the alternate first-line medicines. For me, methylphenidate (Ritalin/Concerta in US) works wonders. Many people seem very happy with Strattera or Adderall. My first few weeks were a rollercoaster, but the negative effects reduced significantly over time as I got used to the medicine and stabilised my dosage. And the positive effects are life-changing.
- corobo 5y ago
  Ritalin (the UK version of anyway) is the one I've been put on yeah. Adderall equiv is on the table if this doesn't work but so far it seems to be the right track
afarviral 5y ago
ADHD meds (psychostimulants) are fast-acting anti depressants. I hope the regiment works out regardless of the underlying condition they're helping you manage, but just another perspective.
- PragmaticPulp 5y ago
  ADHD meds are definitely not antidepressants. A sense of euphoria can be a side effect of early treatment, but that's not to be confused with an actual anti-depressant effect. Some (unfortunately many) users get stuck chasing that initial sense of euphoria with continued dose escalation requests, or by playing games to only take doses on certain days of the week or even by doubling up doses on some days. This is a road you don't want to go down.
  - jnovek 5y ago
    Stimulants do have an anti-depressant quality in a similar sense to SNRIs. They stimulate release of extracellular neural serotonin and norepinephrine (SNRIs block reuptake of serotonin and norepinephrine. Before the accidental discovery of the first front-line antidepressants in the 50s, they were prescribed for depression. However, for the reasons you mentioned, they aren’t very good antidepressants. It’s easy to mistake the early euphoria of amphetamine for reduction in depression. Without careful management, it’s easier to become tolerant or even addicted to amphetamine.
    - PragmaticPulp 5y ago
      Stimulants including Adderall have been formally trialed for depression treatment. They don't work. Don't confuse the molecular mechanism of a drug for its eventual outcome. There is far more to a medication than binding affinities.
      - jnovek 5y ago
        What studies? The information that I’ve found on PubMed and clinicaltrials.gov indicates that this is a poorly studied question, not a decided one. A 2015 survey (Raymond Pary, MD, et al) found evidence that many psychostimulants were effective adjuncts for MDD and Bipolar depression. The results weren’t extraordinary but they were statistically significant. The authors noted in the results that the topic was generally poorly studied and double-blind clinical trials were limited. In 2010-2011 Shire ran Phase II FDA trials on Vyvanse as an adjunct to traditional antidepressants for MDD with mediocre but also statistically significant positive results. Considering the age of most psychostimulants in use, that’s a fairly recent result from a clinical trial. I certainly agree that psychostimulants are not a good choice to treat depression but that’s a far cry from “formally trialed for depression... don’t work”.
subroutine 5y ago
I'm not sure which med you are on, but I've been on adderall for about 12 years. Started during 1st year of a phd program. In my experience with adderall... everything initially good about this particular Rx eventually fades away. Amphetamine makes you feel great. At the beginning really, really, great. It certainly helped me focus on whatever was in front of me, whether it was math homework or an iphone game. It became very important to ensure the right thing(s) were in front of me before taking meds (e.g. homework textbook or open IDE; not, for example, wikipedia, or email, or HN). Not getting enough sleep was the most acute negative effect of the meds. The battle for sleep continues to this day. The meds do suppress my appetite - they still do. It didn't help me lose as much weight as I'd hoped; turns out staring at a computer screen doesn't require a ton of calories. These days I take as little Rx as possible, and I feel a lot better. I attribute a portion of this mood improvement to using a treadmill desk, which I started using ~2 years ago. I walk about 15-20 miles a day, while working (coding/writing/etc). I feel like it helps me focus, because I am "burning off" pent-up ADHD restlessness while working. And probably most helpful of all, I'm tired at the end of the day, so I fall asleep much easier.
- OkayPhysicist 5y ago
  With he sleep thing, I experienced the opposite. The ability to just lay down, decide to sleep, and sleep, combined with a bit of a chemical cue from the comedown really helped to regulate the insomnia I had struggled with since adolescence.
  - sdbrown 5y ago
    This was the biggest benefit for me.
- acrobatsunfish 5y ago
  Can you tell me more about your experience with selection, use, and pitfalls of treadmill desks?
  - subroutine 5y ago
yakattak 5y ago
Obviously different medications have different side effects, but I started taking fluoxetine (Prozac) over a year ago. The first 6-8 weeks were ROUGH. The mood swings were unbearable. It did even out after that and I’m stable now. The night sweats are real though, it’s annoying. My room can be 65° F and I’ll still get them.

by corobo 5y ago

mial 5y ago

Medication helped a lot in the beginning, but what really helped in the long term was talk therapy, and setting up helpful systems and habits such as exercising, diet, journalling. But this would not have been possible without taking Ritalin in the first place. I'm mostly off-meds now.

WhyNotHugo 5y ago
I found the medication useful in interesting ways. While on its effect, I've learn what it feels like to be focused, how ones mind works when in "not easily distracted mode", and I've very slowly learnt to apply some of these things even then not taking the medication.
lostmyoldone 5y ago
This is a good point! Stimulants are not always necessary long term, but they usually are to start effecting enough change to be able to function in the present society. For some (me probably) it'll be a lifelong thing, but it definitely doesn't have to be for everyone! I'm happy for your success! I really wish I had access to more talk therapy, physiotherapy, guided relaxation, mindfullness'ish sessions, and some other forms of support. The medicine helps me to stay mostly functioning, but with talking to a therapist and practicing "basal body knowledge" I was feeling so much better!
corobo 5y ago
I'll be starting the talk therapy side of things soon I believe! Bit of a lag on that due to covid etc. I've already had some systems in place (if it's not in Todoist it's not getting done) but I was falling behind even my norm. If I can get to a point where I can function well enough without meds that will be brilliant, here's to hoping :)

richthegeek 5y ago

Definitely try some of the alternate first-line medicines. For me, methylphenidate (Ritalin/Concerta in US) works wonders. Many people seem very happy with Strattera or Adderall. My first few weeks were a rollercoaster, but the negative effects reduced significantly over time as I got used to the medicine and stabilised my dosage. And the positive effects are life-changing.

corobo 5y ago
Ritalin (the UK version of anyway) is the one I've been put on yeah. Adderall equiv is on the table if this doesn't work but so far it seems to be the right track

afarviral 5y ago

ADHD meds (psychostimulants) are fast-acting anti depressants. I hope the regiment works out regardless of the underlying condition they're helping you manage, but just another perspective.

PragmaticPulp 5y ago
ADHD meds are definitely not antidepressants. A sense of euphoria can be a side effect of early treatment, but that's not to be confused with an actual anti-depressant effect. Some (unfortunately many) users get stuck chasing that initial sense of euphoria with continued dose escalation requests, or by playing games to only take doses on certain days of the week or even by doubling up doses on some days. This is a road you don't want to go down.
- jnovek 5y ago
  Stimulants do have an anti-depressant quality in a similar sense to SNRIs. They stimulate release of extracellular neural serotonin and norepinephrine (SNRIs block reuptake of serotonin and norepinephrine. Before the accidental discovery of the first front-line antidepressants in the 50s, they were prescribed for depression. However, for the reasons you mentioned, they aren’t very good antidepressants. It’s easy to mistake the early euphoria of amphetamine for reduction in depression. Without careful management, it’s easier to become tolerant or even addicted to amphetamine.
  - PragmaticPulp 5y ago
    Stimulants including Adderall have been formally trialed for depression treatment. They don't work. Don't confuse the molecular mechanism of a drug for its eventual outcome. There is far more to a medication than binding affinities.
    - jnovek 5y ago
      What studies? The information that I’ve found on PubMed and clinicaltrials.gov indicates that this is a poorly studied question, not a decided one. A 2015 survey (Raymond Pary, MD, et al) found evidence that many psychostimulants were effective adjuncts for MDD and Bipolar depression. The results weren’t extraordinary but they were statistically significant. The authors noted in the results that the topic was generally poorly studied and double-blind clinical trials were limited. In 2010-2011 Shire ran Phase II FDA trials on Vyvanse as an adjunct to traditional antidepressants for MDD with mediocre but also statistically significant positive results. Considering the age of most psychostimulants in use, that’s a fairly recent result from a clinical trial. I certainly agree that psychostimulants are not a good choice to treat depression but that’s a far cry from “formally trialed for depression... don’t work”.

subroutine 5y ago

I'm not sure which med you are on, but I've been on adderall for about 12 years. Started during 1st year of a phd program. In my experience with adderall... everything initially good about this particular Rx eventually fades away. Amphetamine makes you feel great. At the beginning really, really, great. It certainly helped me focus on whatever was in front of me, whether it was math homework or an iphone game. It became very important to ensure the right thing(s) were in front of me before taking meds (e.g. homework textbook or open IDE; not, for example, wikipedia, or email, or HN). Not getting enough sleep was the most acute negative effect of the meds. The battle for sleep continues to this day. The meds do suppress my appetite - they still do. It didn't help me lose as much weight as I'd hoped; turns out staring at a computer screen doesn't require a ton of calories. These days I take as little Rx as possible, and I feel a lot better. I attribute a portion of this mood improvement to using a treadmill desk, which I started using ~2 years ago. I walk about 15-20 miles a day, while working (coding/writing/etc). I feel like it helps me focus, because I am "burning off" pent-up ADHD restlessness while working. And probably most helpful of all, I'm tired at the end of the day, so I fall asleep much easier.

OkayPhysicist 5y ago
With he sleep thing, I experienced the opposite. The ability to just lay down, decide to sleep, and sleep, combined with a bit of a chemical cue from the comedown really helped to regulate the insomnia I had struggled with since adolescence.
- sdbrown 5y ago
  This was the biggest benefit for me.
acrobatsunfish 5y ago
Can you tell me more about your experience with selection, use, and pitfalls of treadmill desks?
- subroutine 5y ago

yakattak 5y ago

Obviously different medications have different side effects, but I started taking fluoxetine (Prozac) over a year ago. The first 6-8 weeks were ROUGH. The mood swings were unbearable. It did even out after that and I’m stable now. The night sweats are real though, it’s annoying. My room can be 65° F and I’ll still get them.