4 ms·

Depression is such a generic symptom it's often confused with a disease. I maintain that it is not. There are a ton of things that cause depression, and often p

by sph 4y ago

Depression is such a generic symptom it's often confused with a disease. I maintain that it is not. There are a ton of things that cause depression, and often psychiatrists just prescribe an anti-depressant and off you go, especially in countries where doctors have an incentive to medicate people instead of curing them. I've been mildly anxious and depressed all my life, and it's gotten worse in the past few years. Then I learned I might have ADHD, got diagnosed, medicated with a stimulant, and I'm not depressed anymore. I am pretty sure if I had gone to a psychiatrist instead of investing into long term therapy with a psychologist (that eventually suspected I might have ADHD), I would have probably been given an SSRI and sent on my way. I hate imagining how my life would have turned out, yet the sad stories of undiagnosed ADHD sufferers put on SSRI are very common.

semeliussemper 4y ago
Yes, a lot of times people think depression is an illness whereas in fact it is a symptom. It was actually scary to see how easily you can get antidepressants once you mention depression and anxiety. I refused any type of medications because I don't believe there is anything wrong "technically" with my brain, if you gave me $10k it would be perfectly capable of producing hormones of happiness - see no medications were consumed but just the idea of having more money made the brain produce chemicals, so changing the perception of how we see things is crucial imo. I believe only a fraction of clinical cases require antidepressants e.g. major depressive syndrome etc in most cases therapy is the way to go but it is expensive and people don't generally like it they would rather take medications. I think I've made a great deal of progress just being in therapy, practicing meditation, healthy diet etc
roflyear 4y ago
Being sad or sad often is not depression. Depression is a varying level of not being able to be happy even during happy events.
malyalar 4y ago
The comorbidity of anxiety/depression and ADHD can certainly be hard to disambiguate so I’m sorry it took so long to find the right treatment, but it’s also great that you’ve got it now. I do want to point out that a psychiatrist would perform a targeted history of your presentation and mental status exam, and might very well have provided the “correct” diagnosis much sooner—these people do more than prescribe medications on their first hunch. It generally wouldn’t take two years to do a generic review of mental status symptoms. A GP on the other hand might be more pressed with less time to prescribe an SSRI or medication of a related class and put in a referral.
DaftDank 4y ago
> I am pretty sure if I went straight to a psychiatrist instead of investing into long term therapy with a psychologist (that eventually suspected me having ADHD), I would have probably been given an SSRI and sent on my way. That's probably true, but a lot of hospitals try to push this dynamic onto doctors/psychiatrists. When my dad (was psychiatrist for 43 years) took a job as medical director at a hospital in Wyoming, they told him when he first got there that they only wanted his role to be prescribing medication, and that they would have psychologists evaluate the patient first, and then determine what medication is needed and then his job would be to write them. I assume the previous psychiatrist was fine with this (he was an unusual guy in general but that's another story), but my dad told them he would not operate this way. But at the end of the day, the "roles" usually end up being the therapists and psychologists doing the more therapy-focused work, while the psychiatrist makes diagnoses and determinations of which medications may work, and prescribes them because of his M.D. My brother has been bipolar his whole life, major depressive for large parts of it as well, and generally has had a rough time with mental health. It's taken both medication and life-long therapy to get him to a sort of manageable/live-able baseline.
- symlinkk 4y ago
  Lol, it seems like everyone on this website has “ADHD” and “needs” a daily supply of amphetamine just to function. I think the reality is that everyone benefits from amphetamines whether they have ADHD or not, so working backwards, if you feel better on Adderall, that doesn’t mean you have ADHD.
  - amanaplanacanal 4y ago
    Not sure how you got that from what they wrote. They said their psychologist suspected ADHD based on their symptoms and then prescribed medication for it.
    - sph 4y ago
      That is mostly correct: psychologist do not prescribe, psychiatrists do, as they are in fact medical doctors. In my case psychologist made the suggestion I had ADHD after 2 years of therapy, so they knew me pretty well by that point. It all made sense to me, and I went to a psychiatrist to get diagnosed and medicated. Had I gone to a psychiatrist directly, they probably would have prescribed an antidepressant without spending 2 years getting to know me.
mschuster91 4y ago
> There are a ton of things that cause depression, and often psychiatrists just prescribe an anti-depressant and off you go, especially in countries where doctors have an incentive to medicate people instead of curing them. For what it's worth: toxic work culture (=absurd amounts of overtime, lack of mandatory PTO, lack of legal protections for people with mental health issues compared to those with physical health issues) makes it often impossible to actually cure people, not to mention global impacting issues such as unaddressed climate change, the lackluster response to the pandemic or open warfare. To actually remove these contributors or causes of depression and other mental health issues, we'd need a society-wide reform.
- kayodelycaon 4y ago
  In the US, there are significant legal protections around mental health. ADA applies to mental disabilities. And I’m very glad it does. I need accommodations for me to work full-time.

by sph 4y ago

semeliussemper 4y ago

Yes, a lot of times people think depression is an illness whereas in fact it is a symptom. It was actually scary to see how easily you can get antidepressants once you mention depression and anxiety. I refused any type of medications because I don't believe there is anything wrong "technically" with my brain, if you gave me $10k it would be perfectly capable of producing hormones of happiness - see no medications were consumed but just the idea of having more money made the brain produce chemicals, so changing the perception of how we see things is crucial imo. I believe only a fraction of clinical cases require antidepressants e.g. major depressive syndrome etc in most cases therapy is the way to go but it is expensive and people don't generally like it they would rather take medications. I think I've made a great deal of progress just being in therapy, practicing meditation, healthy diet etc

roflyear 4y ago

Being sad or sad often is not depression. Depression is a varying level of not being able to be happy even during happy events.

malyalar 4y ago

The comorbidity of anxiety/depression and ADHD can certainly be hard to disambiguate so I’m sorry it took so long to find the right treatment, but it’s also great that you’ve got it now. I do want to point out that a psychiatrist would perform a targeted history of your presentation and mental status exam, and might very well have provided the “correct” diagnosis much sooner—these people do more than prescribe medications on their first hunch. It generally wouldn’t take two years to do a generic review of mental status symptoms. A GP on the other hand might be more pressed with less time to prescribe an SSRI or medication of a related class and put in a referral.

DaftDank 4y ago

> I am pretty sure if I went straight to a psychiatrist instead of investing into long term therapy with a psychologist (that eventually suspected me having ADHD), I would have probably been given an SSRI and sent on my way. That's probably true, but a lot of hospitals try to push this dynamic onto doctors/psychiatrists. When my dad (was psychiatrist for 43 years) took a job as medical director at a hospital in Wyoming, they told him when he first got there that they only wanted his role to be prescribing medication, and that they would have psychologists evaluate the patient first, and then determine what medication is needed and then his job would be to write them. I assume the previous psychiatrist was fine with this (he was an unusual guy in general but that's another story), but my dad told them he would not operate this way. But at the end of the day, the "roles" usually end up being the therapists and psychologists doing the more therapy-focused work, while the psychiatrist makes diagnoses and determinations of which medications may work, and prescribes them because of his M.D. My brother has been bipolar his whole life, major depressive for large parts of it as well, and generally has had a rough time with mental health. It's taken both medication and life-long therapy to get him to a sort of manageable/live-able baseline.

symlinkk 4y ago
Lol, it seems like everyone on this website has “ADHD” and “needs” a daily supply of amphetamine just to function. I think the reality is that everyone benefits from amphetamines whether they have ADHD or not, so working backwards, if you feel better on Adderall, that doesn’t mean you have ADHD.
- amanaplanacanal 4y ago
  Not sure how you got that from what they wrote. They said their psychologist suspected ADHD based on their symptoms and then prescribed medication for it.
  - sph 4y ago
    That is mostly correct: psychologist do not prescribe, psychiatrists do, as they are in fact medical doctors. In my case psychologist made the suggestion I had ADHD after 2 years of therapy, so they knew me pretty well by that point. It all made sense to me, and I went to a psychiatrist to get diagnosed and medicated. Had I gone to a psychiatrist directly, they probably would have prescribed an antidepressant without spending 2 years getting to know me.

mschuster91 4y ago

> There are a ton of things that cause depression, and often psychiatrists just prescribe an anti-depressant and off you go, especially in countries where doctors have an incentive to medicate people instead of curing them. For what it's worth: toxic work culture (=absurd amounts of overtime, lack of mandatory PTO, lack of legal protections for people with mental health issues compared to those with physical health issues) makes it often impossible to actually cure people, not to mention global impacting issues such as unaddressed climate change, the lackluster response to the pandemic or open warfare. To actually remove these contributors or causes of depression and other mental health issues, we'd need a society-wide reform.

kayodelycaon 4y ago
In the US, there are significant legal protections around mental health. ADA applies to mental disabilities. And I’m very glad it does. I need accommodations for me to work full-time.