Depression

Rajaah · 2025-10-01T08:45:51-0400

Daidraco said:
The anger you attribute to it isnt really what you're thinking - its that you actually give a shit about things now. Instead of being some weak willed, apathetic, piece of shit, sulking on the couch.

That actually describes it perfectly, I think you nailed it.

In that case, add me to the proponents of TRT because the good vastly outweighs the bad.

Now I just need to get my doctor to put me on an actual TRT program (I'm getting shots via a medical study, and only get 3 shots out of the deal - one in early Sept, one in early Oct, one in early Dec).

Aldarion · 2025-10-01T08:53:22-0400

Izo said:
Precisely why we prescribe it. Choice of drug is complex, moderat vs severe depression, manic vs non manic episodes, interactions with other drugs taken etc etc. SSRI is standard for moderate depressions, SNRI for severe. So a SSRI like prozac (fluoxetine) is an option, we use sertraline over here mostly, which is good for social anxiety and social phobia as well as moderate depression.

Treatment is never drugs alone, always combined with therapy and doctor supervision along the way.

Hope you get on top eventually, Koushirou <3 (oblig. Giggity)

One of the major problems we object to here in the US is that once someone is on SSRIs, the doctors basically never advise you to get off them.

Oh if you ask them right out, yeah they'll agree its not a lifelong solution. But speaking from secondhand experience, they never actually suggest anyone stop taking them. Literally never. And from firsthand experience, when I told mine I wanted to stop he was like "eh ok if you think you need to", but sure didnt suggest it or offer any advice in that direction. Hell, he oftensuggested I could increase the dose.

Since you're in here advocating them - do they do it differently over there? Or is it a de facto lifelong treatment there too?

moonarchia · 2025-10-01T09:49:41-0400

Daidraco said:
I've been a proponent of TRT for several years now. Changed my life for the better. Definitely got me out of my "funk" as Ive aged and you know me, Raj - Im a bit younger than you. Pharms/Docs are still going to be like "its bad for you" because of the possible heart conditions it may bring and similar. But I lost a ton of weight, and Im much more active now. So in my head, I would have died to heart disease or a stroke much sooner without TRT. The muscle mass you gain just from being active will probably make getting around easier as you age, too. The anger you attribute to it isnt really what you're thinking - its that you actually give a shit about things now. Instead of being some weak willed, apathetic, piece of shit, sulking on the couch.

I'll have you know I don't even *own* a couch!

Deathwing · 2025-10-01T09:57:13-0400

Where do you take naps?

moonarchia · 2025-10-01T09:59:34-0400

Deathwing said:
Where do you take naps?

What's a nap?

Burren · 2025-10-01T10:45:50-0400

Rajaah said:
That actually describes it perfectly, I think you nailed it.

In that case, add me to the proponents of TRT because the good vastly outweighs the bad.

Now I just need to get my doctor to put me on an actual TRT program (I'm getting shots via a medical study, and only get 3 shots out of the deal - one in early Sept, one in early Oct, one in early Dec).

That will be completely ineffective. 1mL split in half, taken twice a week. It’s a hormone that needs consistency and it has a short half life in the system. You can do shots at home and a quality sports medicine clinic will mail you 60 days worth of TRT, needles, syringes, and alcohol wipes for under $200/mo.

Izo · 2025-10-01T12:59:59-0400

moonarchia said:
Guns don't kill people. Joggers kill people?

~~Koushirou~~

Brahma is black?!?

Izo · 2025-10-01T13:20:30-0400

Aldarion said:
One of the major problems we object to here in the US is that once someone is on SSRIs, the doctors basically never advise you to get off them.

Oh if you ask them right out, yeah they'll agree its not a lifelong solution. But speaking from secondhand experience, they never actually suggest anyone stop taking them. Literally never. And from firsthand experience, when I told mine I wanted to stop he was like "eh ok if you think you need to", but sure didnt suggest it or offer any advice in that direction. Hell, he oftensuggested I could increase the dose.

Since you're in here advocating them - do they do it differently over there? Or is it a de facto lifelong treatment there too?

That's unfortunate, indeed.

Depression is complex, can be complicated to diag and treat, which clouds the general populations understanding of treatment regimes. Mono/unipolar, treatment resistant depression, bipolar, schizephrenia, anxiety, ptsd, substance abuse, genetics etc. Hence sometimes treatment might be "forever", like in the non-unipolar options. Usually not for unipolar.

We don't have student loans to pay off. Education is free. Healthcare is mainly public with <5% privare sector. It's forbidden by law to recieve any form of kickback or enticements from the pharmaceutical industry. So we don't have a vested interest in keeping you hooked or do unnnecesary treatments. The cosmetic / plastic surgery is different obviously - <arnold tits tits tits.gif>

As for treament options and regimes, it's good practice to evaluate closely during startup, e.g. increased risk of side effects. Once it's up and running, it's good practice to at least reevaluate once a year. Here is a standard evaluation aid if treatment should be continued, translated by chatgpt, for unipolar depression.

Here is an English translation of Table 4: Examples of Key Points in Counseling a Patient Regarding Continuation of Antidepressant Medication from the Medicin.dk guideline:

Examples of focus points Arguments in favor of discontinuation Arguments in favor of continuation
Unacceptable side effects +
Uncertain diagnosis +
No prior severe depressions +
Lack of effect +
Residual symptoms +
Persistent psychosocial stress +
Predisposition to bipolar disorder* +
Development of signs of hypomania/mania* +
Previous hypomania/mania* +
Previous suicidal risk +
Previous depression difficult to treat +
More than two episodes +
Early onset +
Chronic somatic disease +
Psychiatric comorbidity (e.g. anxiety) +
Psychotic depression +

* Involvement of a psychiatric specialist should be considered.

Hateyou · 2025-10-01T14:50:08-0400

Koushirou said:
Seeing a psychiatrist tomorrow to possibly put me on anti-depressants. I don’t want to, but I don’t want to be admitted either, which was starting to become a possibility. I want to die, but I don’t want to want to die, if that makes any sense. Again, I don’t want to be on some bullshit, but it’s pretty clear I’m not capable of pulling myself out of this shit. Maybe it’ll help, IDK.

Fucking do not do this if you can avoid it. I don’t know a single person that was helped by anti-depressants.

Get up and force yourself to do shit is the only advice I have. Get on Meetup and punch in some interests and force yourself to go to local events where you have to interact with people. The nerdier the better.

Cad · 2025-10-01T15:56:13-0400

Izo said:
It's forbidden by law to recieve any form of kickback or enticements from the pharmaceutical industry. So we don't have a vested interest in keeping you hooked or do unnnecesary treatments.

Same here btw in case you're not familiar with US law. (For doctors who are the prescriber gateway to all the drugs).

Koushirou · 2025-10-01T19:24:28-0400

Better day today. Missed my two gym days last week due to parents being in town, but got back to it today and had a good session. I don't usually decorate shit for seasons/holidays, but went ahead and busted out some Halloween stuff for the kitchen and the porch and set that all up. Also fixed my flag pole that's been broken for a while and got Ol' Glory back up and flying. Tidied up some random shit laying around the house that's been sitting there for a while and made a list of other shit I want to knock out in the next few days. Neighborhood is doing a community yard sale this weekend, so got a bunch of shit together to put out for that and hopefully clean out my garage a bit (family basically tossed me nearly an entire bathroom's worth of fixtures, sink, toilet, tile, etc. that I doubt I'll ever get to using at this point). Also found there's an in-person depression support group in town that meets once a month, so it's a toss up of me going to that or going to the Highland Festival (I love these things, but I guess the support group would be more useful, heh). Also grabbed a meditation app a while back and have been trying to be consistent about using it everyday this week.

Overall, trying to take the advice here and reduce my focus to just today or the next few days. I know I'm retarded and frustrating when it comes to this shit, but I do appreciate everyone's help.

Control · 2025-10-01T19:31:41-0400

Koushirou said:
busted out some Halloween stuff

post pics of the cats in the jackolantern. it will help.

sleevedraw · 2025-10-01T19:35:13-0400

Koushirou said:
Better day today. Missed my two gym days last week due to parents being in town, but got back to it today and had a good session. I don't usually decorate shit for seasons/holidays, but went ahead and busted out some Halloween stuff for the kitchen and the porch and set that all up. Also fixed my flag pole that's been broken for a while and got Ol' Glory back up and flying. Tidied up some random shit laying around the house that's been sitting there for a while and made a list of other shit I want to knock out in the next few days. Neighborhood is doing a community yard sale this weekend, so got a bunch of shit together to put out for that and hopefully clean out my garage a bit (family basically tossed me nearly an entire bathroom's worth of fixtures, sink, toilet, tile, etc. that I doubt I'll ever get to using at this point). Also found there's an in-person depression support group in town that meets once a month, so it's a toss up of me going to that or going to the Highland Festival (I love these things, but I guess the support group would be more useful, heh). Also grabbed a meditation app a while back and have been trying to be consistent about using it everyday this week.

Overall, trying to take the advice here and reduce my focus to just today or the next few days. I know I'm retarded and frustrating when it comes to this shit, but I do appreciate everyone's help.

Two things about meditation:

(1) It's definitely not a one-size-fits-all thing, and if you find one modality doesn't work for you, don't immediately discount all forms of meditation. Speaking just for me personally, I can't do anything like guided imagery because it just comes across as super hokey to be trying to envision myself walking along a beach. But deep breathing works well. And there's different subtypes of deep breathing; you can do progressive muscle relaxation, box breathing, 4/7/8, so forth. Lots of stuff to try.

(2) It's a lot like exercise in that you get accustomed to it the more you do it. While I don't always like the content of the apps, I do like them from the perspective of sending a push notification/nudge to you to remind you to do it. It's the consistency that is the key.

Koushirou · 2025-10-01T19:38:07-0400

Control said:
post pics of the cats in the jackolantern. it will help.
View attachment 604161

No jack-o-lanterns here, but I do have these cute little cat figures I found at a gift shop that matched Arya and Bruce. Made sure to hide them before the ex moved out because I wanted to keep something of my little man.

Rajaah · 2025-10-01T19:47:05-0400

Burren said:
That will be completely ineffective. 1mL split in half, taken twice a week. It’s a hormone that needs consistency and it has a short half life in the system. You can do shots at home and a quality sports medicine clinic will mail you 60 days worth of TRT, needles, syringes, and alcohol wipes for under $200/mo.

Not to derail the depression thread, but that isn't what's happening over here. The study I'm in gave me a significant dose and I believe it's in some sort of "extended release" format. They said it probably wouldn't even have much of an effect until around two weeks later. I believe it's supposed to have a much more significant impact in October once the second shot doubles up on it. I do wonder why they're skipping a month before the third shot, and suspect that's part of the study (to see how much of it wears off and when).

I never noticed a changeover where I suddenly felt better. Was more like I realized recently that I've been like 5x more productive than normal for the past several weeks and far more motivated as well. Looking back in retrospect, this started probably around two weeks after I got the first shot. I wasn't looking for it, so I doubt it's a placebo effect. It's unmistakable though and it's huge. Basically de-aged me ten years and I haven't felt it subside yet (if anything it seems to get stronger over time).

TLDR, I think these are extended-release that are supposed to last around 45 days and can take two weeks to get up and running on the first shot. Once you get going with one shot every 30-40 days or so, it stays in the system.

Obviously I'm no expert on how TRT is supposed to function, but I can bring any questions to them when I see them again in a few days.

Sanrith Descartes · 2025-10-01T20:45:06-0400

Koushirou said:
Better day today. Missed my two gym days last week due to parents being in town, but got back to it today and had a good session. I don't usually decorate shit for seasons/holidays, but went ahead and busted out some Halloween stuff for the kitchen and the porch and set that all up. Also fixed my flag pole that's been broken for a while and got Ol' Glory back up and flying. Tidied up some random shit laying around the house that's been sitting there for a while and made a list of other shit I want to knock out in the next few days. Neighborhood is doing a community yard sale this weekend, so got a bunch of shit together to put out for that and hopefully clean out my garage a bit (family basically tossed me nearly an entire bathroom's worth of fixtures, sink, toilet, tile, etc. that I doubt I'll ever get to using at this point). Also found there's an in-person depression support group in town that meets once a month, so it's a toss up of me going to that or going to the Highland Festival (I love these things, but I guess the support group would be more useful, heh). Also grabbed a meditation app a while back and have been trying to be consistent about using it everyday this week.

Overall, trying to take the advice here and reduce my focus to just today or the next few days. I know I'm retarded and frustrating when it comes to this shit, but I do appreciate everyone's help.

moonarchia · 2025-10-01T23:24:00-0400

Control said:
post pics of the cats in the jackolantern. it will help.
View attachment 604161

Not sure if that unlocks a new fear, but that is both adorable and deeply disturbing. Like fluffy little maggots crawling out of a corpse.

Koushirou Good job, team!

Cutlery · 2025-10-02T07:38:09-0400

Koushirou said:
Better day today. Missed my two gym days last week due to parents being in town, but got back to it today and had a good session. I don't usually decorate shit for seasons/holidays, but went ahead and busted out some Halloween stuff for the kitchen and the porch and set that all up. Also fixed my flag pole that's been broken for a while and got Ol' Glory back up and flying. Tidied up some random shit laying around the house that's been sitting there for a while and made a list of other shit I want to knock out in the next few days. Neighborhood is doing a community yard sale this weekend, so got a bunch of shit together to put out for that and hopefully clean out my garage a bit (family basically tossed me nearly an entire bathroom's worth of fixtures, sink, toilet, tile, etc. that I doubt I'll ever get to using at this point). Also found there's an in-person depression support group in town that meets once a month, so it's a toss up of me going to that or going to the Highland Festival (I love these things, but I guess the support group would be more useful, heh). Also grabbed a meditation app a while back and have been trying to be consistent about using it everyday this week.

Overall, trying to take the advice here and reduce my focus to just today or the next few days. I know I'm retarded and frustrating when it comes to this shit, but I do appreciate everyone's help.

Lotta days are like this

Hateyou · 2025-10-02T07:50:26-0400

Rajaah said:
Not to derail the depression thread, but that isn't what's happening over here. The study I'm in gave me a significant dose and I believe it's in some sort of "extended release" format. They said it probably wouldn't even have much of an effect until around two weeks later. I believe it's supposed to have a much more significant impact in October once the second shot doubles up on it. I do wonder why they're skipping a month before the third shot, and suspect that's part of the study (to see how much of it wears off and when).

I never noticed a changeover where I suddenly felt better. Was more like I realized recently that I've been like 5x more productive than normal for the past several weeks and far more motivated as well. Looking back in retrospect, this started probably around two weeks after I got the first shot. I wasn't looking for it, so I doubt it's a placebo effect. It's unmistakable though and it's huge. Basically de-aged me ten years and I haven't felt it subside yet (if anything it seems to get stronger over time).

TLDR, I think these are extended-release that are supposed to last around 45 days and can take two weeks to get up and running on the first shot. Once you get going with one shot every 30-40 days or so, it stays in the system.

Obviously I'm no expert on how TRT is supposed to function, but I can bring any questions to them when I see them again in a few days.

Extended release…liquid injection?

Burren · 2025-10-02T08:14:24-0400

Hateyou said:
Extended release…liquid injection?

Exactly. That isn’t a thing.

Examples of focus points	Arguments in favor of discontinuation	Arguments in favor of continuation
Unacceptable side effects	+
Uncertain diagnosis	+
No prior severe depressions	+
Lack of effect	+
Residual symptoms		+
Persistent psychosocial stress		+
Predisposition to bipolar disorder*	+
Development of signs of hypomania/mania*	+
Previous hypomania/mania*	+
Previous suicidal risk		+
Previous depression difficult to treat		+
More than two episodes		+
Early onset		+
Chronic somatic disease		+
Psychiatric comorbidity (e.g. anxiety)		+
Psychotic depression		+

Depression

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