Ask HN: What is your experience with SSRIs?

Let's imagine that for any desired outcome you can empirically derive a function of the form:

success ~= ability * effort * environment

Let's take your effective intelligence as your measure of success.

Then your ability is your innate capacity for intellectual activity, your effort is how you apply yourself in situations that require intellect, and your environment is everything else about your life, including your capacity for motivating yourself.

Taking properly prescribed psychiatric medicine will dramatically change the environment in which you are applying your intelligence.

If your environment is otherwise driving your effective intelligence down to zero, is there really a risk?

You do have other options such as therapy. I would recommend going that route if you can. If you can't, or that doesn't work, medication can be a good way to dig you out of this situation.

It sounds like your situation is bad enough to warrant some risks.

I did see a counselor for about 6 months, and I was kicked out in June, as they believed I required a higher level of care, such as an intensive outpatient program and/or an SSRI.

I've attempted to read books on OCD. I've attempted Exposure-Response Prevention on my own with limited success. I reach a wall. I don't want to experience the seemingly endless stress that I'd endure from the most significant exposures and I shutdown.

SSRIs feel like a forced mood lift. Like Coca Cola gives you a sugar high. It has that same artificial-chemical vibe, just inside your brain. You are aware you are less depressed, and it's not from you, that's about it. You reason and perform intellectual tasks at the same pace as before, just less ruminating and negative mood.

They also kill your sex drive and can cause some difficultly in the act of sex. This has few studies but needs more. It's unfortunately underexplored. For some people this is a feature and not a bug.

The come down from the artficial mood lift can be unpleasant, it doesn't take long to get used to, but it can be a source of moodiness if you're not aware of what the experience of coming down is like.

It won't sterilize or neuter your brain. Taking it is likely orders of magnitude better than not taking it. Not because SSRIs are a pancea, but because getting out of bed is so much better than staying inside all day and SSRIs might help.

30mg of Saffron (yes the spice) is a more pleasant mood lifter, even though it tastes quite bitter. It shares some qualities with SSRIs and other meds.

Being always-online can feed ritual and delusion just as much as it distracts you from them. The intellectual content on the internet eventually turns into theology if you go far enough with it. Prayer and faith can help see through rituals and delusions clearly.

I'm a residency trained pharmacist and someone whose life was improved immensely by antidepressants from ages 19 - 37(bupropion x 10+ years, SSRI x 2 years, SNRI x 5 years). These drugs will change your affect (your mood) but not your intellect.

I am also currently not on medication x 2 months for the first time in about 18 years, so I have seen myself both on and off meds and I have a deep mechanistic understanding of these drugs.

I promise you that no drug that you can take can make any permanent changes to *edit* to your mind (there are rare cases unrelated to SSRI where side effects like tardive dyskinesia or pulmonary fibrosis can be irreversible). The SSRI have about a 4-6 week period of onset and offset where the extra serotonin floating around starts to cause fewer serotonin receptors to be expressed and subsequently enhances your brain's sensitivity to serotonin. It is for this reason that you do not see results overnight when starting a serotonergic drug.

Stopping the drug, a similar effect is seen. I had about a week of slight discomfort related to withdrawal symptoms, then 2-3 weeks of feeling a bit slower than normal, and now I feel just fine. Throughout this whole brain remodeling process both on and off meds, I never lost a step at work, which is to say that I maintained excellent performance as a midlevel practitioner and maintained several side hustles and even started a consulting business.

My honest interpersonal advice (not medical advice) is to give meds a try man. Your life has been severely affected by your mental state, and you could potentially see significant improvement....but even if you dont, you'll stop the drug and be no worse off than when you started.