Depression

Disclaimer: not a medical professional, but I've spent a lot of time professionally (about 12 years) working with people who are dealing with things like depression, anxiety, bipolar, etc. I make a lot of assessments/referrals, talk to a lot of doctors about treatment, treatment plans, patient needs, etc. I've learned a lot of things over the years, but keep in mind my advice is based only on my own personal experience- NOT any form of medical expertise.

This may have been mentioned previously in this thread, but if you are having issues finding a medication that works in treating depression, you may want to consider trying ketamine. It's not a new drug, but its use as an anti-depressant is fairly new. It's not an SSRI or a TCA. One dose can last several weeks. I've known several people that have tried tons of traditional anti-depressants without result who have had immediate success with ketamine. I'm not much on hyperbole and I don't believe in "miracle solutions" but the people I know who have tried this have described its effects as nothing short of miraculous.

Again, I'm not a medical professional- so talk to yours. Even though the cases I've seen have all been very positive, the wiki on it seems to come with some warnings Ketamine - Wikipedia.

My second piece of advice is talk to a psychiatrist if you are looking for help getting the right meds and the right dosage. Not a GP, not a psychologist, but a psychiatrist. Psychologists are great for diagnosing and therapy, but when it comes to meds, seeing a psychiatrist instead of just getting a script from your GP can make a world of difference.

Final piece of advice- I've found these things to be surprisingly effective:

The evidence for ketamine is still pretty sketchy. They've found it is likely activating the pleasure center in the brain the same way alcohol and opioids do. With that in mind, its going to be hard to prove its actually helping vs. just causing euphoria. Also, the intranasal administration is a logistical pain in the dick in my clinic. The hospital system I work for talks about doing it but they don't want to pay my office staff to monitor the patient as required.

It's been 4 days now. No word. Just silence. Are you there? Are you alive? I can feel I'm slipping into darkness, into dispair.

hodj , come back to us.

Paxil is notorious for causing sexual side effects.

Ya, but Paxil is called "Pecker Wrecker" in the biz for a reason.

Really just Wellbutrin. It's a common side effect of all serotonergic antidepressants (Paxil just does it more).

TMS is actually pretty sweet for treating depression and is actually supported by scientific evidence.

TMS can cause a seizure if you lie about how much you've been drinking or take a bunch of Wellbutrin/TCA prior to treatment. Aside from some people complaining of scalp discomfort, its safer than medication.

Arden said:

Disclaimer: not a medical professional, but I've spent a lot of time professionally (about 12 years) working with people who are dealing with things like depression, anxiety, bipolar, etc. I make a lot of assessments/referrals, talk to a lot of doctors about treatment, treatment plans, patient needs, etc. I've learned a lot of things over the years, but keep in mind my advice is based only on my own personal experience- NOT any form of medical expertise.

This may have been mentioned previously in this thread, but if you are having issues finding a medication that works in treating depression, you may want to consider trying ketamine. It's not a new drug, but its use as an anti-depressant is fairly new. It's not an SSRI or a TCA. One dose can last several weeks. I've known several people that have tried tons of traditional anti-depressants without result who have had immediate success with ketamine. I'm not much on hyperbole and I don't believe in "miracle solutions" but the people I know who have tried this have described its effects as nothing short of miraculous.

Again, I'm not a medical professional- so talk to yours. Even though the cases I've seen have all been very positive, the wiki on it seems to come with some warnings Ketamine - Wikipedia.

My second piece of advice is talk to a psychiatrist if you are looking for help getting the right meds and the right dosage. Not a GP, not a psychologist, but a psychiatrist. Psychologists are great for diagnosing and therapy, but when it comes to meds, seeing a psychiatrist instead of just getting a script from your GP can make a world of difference.

Final piece of advice- I've found these things to be surprisingly effective:

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I haven't used that particular light, but installing f.lux on my laptop to filter out blue light in the evening instantly fixed my insomnia a few years ago. Your eyes even adjust so can't tell there's no blue most of the time.

I've actually had pretty consistent anxiety and depression since leaving college. This culminated to panic attacks and a few trips to the ER per year until I was prescribed Paxil. As mentioned above, Paxil wasn't a great fit. Yes, you didn't feel worried so much and in-turn were less depressed, but you also were less a lot of things. It felt like life with the volume turned down and after my aunt (who I was closed to) passed away and I couldn't even shed a tear, I was like...wtf am I doing?

Next was a small dose of xanax if I felt overwhelmed. When you start taking this 3-5 days a week it just seemed like I was treating a symptom and not the cause. I also didn't want to become dependent on this drug as I've seen what happens to people who do (live your life with your eyes closed...you won't even remember doing things). So strike 2.

I was then introduced to citalopram like 6 years ago after getting a promotion at work and subsequently losing my damned mind in stress. In the end, I was assigned an area that was lower priority but high mix/issues. Being an engineer I felt it was my job to correct all of this as well as learn the management side of it. Trying to do this was literally pulling me apart and citalopram really helped calm my mind enough to realize that not everything is a crisis, some things can wait, and hell some of it maybe just has to be that way due to availability of resources / business decisions. Of all medications I have experienced, citalopram had the most beneficial effect.

Over the past several years I have learned to prioritize work and don't sweat the small stuff. I haven't been to the ER for a panic attack in this period (something that even with xanax would still happen on occasion) and generally speaking have had a happier life. That said, I still feel like I'm not quite addressing the root of the issue. I picked up on a personality trait of mind that I think is a major contributor. Procrastination. I procrastinate...a LOT. It is not laziness that drives me to do this though, so much as it is the only way I can get my mind to calm down enough to focus on the task that I know needs to be done.

So it's a pretty direct link to realize that putting off important work until it is red hot will create stress. I can use that stress to focus and be successful. Somehow I have done really well career wise inspite of all of it all, but there has to be a better way right? I've been a few months off of citalopram now and it "feels" like, for lack of a better way to express it, that I have learned how to manage priority on that drug and no longer need it for that function. There definitely is a sexual muting that goes along with these drugs, and citalopram was no exception, so it's nice to not deal with that side-effect.

I've got an appointment with a psychiatrist for the first time in my life next week (have always had an aversion to them). My hypothesis is I tend to have mild expression of ADD and OCD characteristics, that I deal with pathologically by procrastination (or sometimes I will drink just so I can focus, which only half-assed works because you invariably drink too much in the process). The procrastination creates stress, which leads to anxiety and depression. It isn't simply my professional career where I've noted this, but I've had similar issues going back to when I was a kid that in retrospect really fit the hypothesis (no homework, skipping chores, read an entire encyclopedia one summer, voted most intelligent and likely to succeed in high school, but kicked out of national honor society because I could give 2 shits about classes, could play video games for days on end, etc.). I also have a nephew who was diagnosed as ADD recently and prescribed adderral. My sister says he reminded her of me when I was a kid, but is night-and-day different when medicated.

Anyway, not sure if that journey will help anyone relate to their own but I think depression is clearly sourced from a lot of different causes. We each have to take some time to be reflective and work to understand the underlying root causes. Just taking meds and expecting it all to go away (a passive approach) will not get you where you really want to be. My 2 cents.

Scoresby said:

I've got an appointment with a psychiatrist for the first time in my life next week (have always had an aversion to them). My hypothesis is I tend to have mild expression of ADD and OCD characteristics, that I deal with pathologically by procrastination (or sometimes I will drink just so I can focus, which only half-assed works because you invariably drink too much in the process). The procrastination creates stress, which leads to anxiety and depression. It isn't simply my professional career where I've noted this, but I've had similar issues going back to when I was a kid that in retrospect really fit the hypothesis (no homework, skipping chores, read an entire encyclopedia one summer, voted most intelligent and likely to succeed in high school, but kicked out of national honor society because I could give 2 shits about classes, could play video games for days on end, etc.). I also have a nephew who was diagnosed as ADD recently and prescribed adderral. My sister says he reminded her of me when I was a kid, but is night-and-day different when medicated.

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Sounds very familiar.

I was only ever prescribed Citalopram, it put in a floor of how low I could feel which cut off all of the worst depression symptoms. I came off it because of the sexual muting as you describe, but I was better by then.

My personality and situation is very much as you describe, I procrastinate constantly with study/work which causes stress. However I can get really passionate about things and read encylopedias for fantasy universes or game for hours and make spreadsheets for the mechanics of those games to master them. That then causes depression as it wears you out mentally, like typing this post is doing.

This book really helped me not stress as much about small things and recognise when to back off things that are wearing you out:

I guess I am backwards. I get depressed when I prioritize work and just gloss over all the other things going on around me that most people would just call their life. Had a lot of conversations with various people over the last month that pointed out a lot of stuff I just missed or never paid any attention to, going back a very long time. I didn't get depressed while it was happening, just mostly when it was pointed out to me.

No that kinda sounds right. I guess it depends on the mental intention.

A lot of men will prioritize work exactly so that they DON'T have to deal with the shit going on in the other aspects of life. They prioritize work as an avenue to control depression.

It's extremely functional. Who gives a fuck how you feel, just get the job done. But it can lock you into an entire lifetime of feeling like shit and alcoholism.

I don't drink. Just the last few weeks had several conversations with friends and family. Suff going back 30+ years. Even before I really got into just avoiding people entirely I avoided people thru various ways according to those that knew me then.

Arden said:

This may have been mentioned previously in this thread, but if you are having issues finding a medication that works in treating depression, you may want to consider trying ketamine. It's not a new drug, but its use as an anti-depressant is fairly new. It's not an SSRI or a TCA. One dose can last several weeks. I've known several people that have tried tons of traditional anti-depressants without result who have had immediate success with ketamine. I'm not much on hyperbole and I don't believe in "miracle solutions" but the people I know who have tried this have described its effects as nothing short of miraculous.

Click to expand...

Ketamine is a recreational class A drug here in the UK. Not my thing, only tried it a couple of times and never saw the point but I knew a lot of people that would be on it every weekend.

You can't just tell people to randomly try it on a message board, lol