Ask HN: Beating depression with or without anti-depressants?

I took antidepressants for about five years at the suggestion of my primary care doc at a time when I knew the floor was about to fall out at work and I'd need help to cope with the stress.

I made it through until the project was over and then I quit.

In that time frame I was sometimes between jobs, sometimes trying to sell solutions for the financial services industry, sometimes doing consulting, sometimes working at startups.

The most obvious side effect I had was suppression of my sexual response. It wasn't eliminated, but it was reduced, it took me more time to come to an orgasm, and when the orgasm came it wasn't a single event but rather I could perceive a number of separate events... Sometimes the result was fantastic, sometimes it would fall flat. I was capable of having sex for an hour, not have an orgasm, having sex the next morning for 20 minutes and having an orgasm, etc.

After I had settled in at a steady job my primary care physician said I should try quitting. A few weeks after I did I had a few incidents where I'd get furious about messes that hadn't been cleaned up for years... One day I got 45,000 steps on a day when I didn't leave the house.

My libido came back with full force and then I started having conflicts with my wife about her being less interested in sex. That's still an ongoing misadventure.

I'm not sure if this totally out of left-field, but have you tried dietary change like a ketogenic or other type of restrictive diet? I know that for some people some foods can trigger horrible mood changes like bipolar, anger, feelings of fear, depression, etc.. Especially if you're sensitive to some foods like gluten, dairy, certain meats & veggies, etc. Also if you ingest any other drugs/chemicals it would be worth considering their effects too (nicotine, caffeine, alcohol, weed, etc).

I think if there is no other option SSRIs can help but I've also seen them have bad side effects (especially when taken long-term). Of course you gotta pick the lesser of the evils.. curious if you've looked into this at all:

https://pubmed.ncbi.nlm.nih.gov/34949933/ https://pubmed.ncbi.nlm.nih.gov/30075165/ https://pubmed.ncbi.nlm.nih.gov/31568812/ https://pubmed.ncbi.nlm.nih.gov/31336509/ https://pubmed.ncbi.nlm.nih.gov/30037619/ https://pubmed.ncbi.nlm.nih.gov/29914664/

> So HN, what has your experience been with depression? Have you tried the drugs? What worked or didn't? Have you been able to triumph without chemical assistance and what did that look like? Is my utter terror of these drugs warranted or should I just bite the bullet and try them?

A lot of friends have ended up on prozac or other drugs, with profoundly hit or miss results.

I've struggled at times, but found that vitamin D, magnesium, zinc, decent amount of protein, and good sleep did a lot for me. Regular outside activities, even if just walks, or exercise also a lot for me.

Keep in mind I live in Western Canada, so my walks often happen in -30C weather.

Also just finding something that produces joy was big. Not fun, not cool -- joy. Making less money and doing more things that bring me joy made a big difference. Most of the people I know making "the big money" are miserable people.

> These drugs are very powerful but have really bad side-effects for most people that take them

for people that take larger doses and for longer periods, you're going to be dealing with that more frequently. It's not quite binary - there's a number of different drugs with different results for different people. By not talking to a doctor you are only keeping yourself in the dark - this is fine, but you are limiting your field of options. If you've got some timeline/end goal where you can define your life as less stressful, you could go on them to buckle down (if alternatives arent working and the duration makes sense), but unless that timeline then results in another change to your whole health situation, you haven't done much but avoid the problem.

personal experience: needed them in order to get here, ran out of reasons to take them, dropped them (15~ years)

Eat healthy, go for walks, talk to a professional, open up to family and friends. Don’t be afraid of taking medication or changing your career. Don’t be afraid of admitting to yourself what you actually want out of life.

Don’t expect it to be easy.

The nice thing about medication is if you forget to take a pill today it is very easy to take one tomorrow. You can also stop when ever you want. Best case, they are a crutch that helps you until you can walk again. Worst case, you’ll live an undepressed life with them.

If you self-treat in the gym, it can be very difficult to haul your sorry ass back there if you miss a day.

> I have tried therapy

The worst thing about therapy is finding a therapist. It’s an awful process that one needs to do in a time in your life when you are not capable.

I don’t know you, but you asked for internet stranger advice: mine is to keep looking for a therapist you like and have them be part of your healing process together with medication. Don’t stop seeing a therapist just because you start to feel good when the medication kicks in.