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

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

#211

PLEASE do not read any of these people's advice. Talk to a MEDICAL PROFESSIONAL, preferably a DOCTOR. DO NOT trust your mental health to strangers on the internet, be it reddit, or hacker news, or whatever. If you are based in the US and live nearby a university they usually have good counseling services and the infrastructure to refer people even if you're not attending the school. Search "{school} counseling servic…

My doctor is a fucking idiot. I also went to a university counseling service and they didn’t do shit. Never followed up or anything after the one consultation appointment I had.

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

#212

PLEASE do not read any of these people's advice. Talk to a MEDICAL PROFESSIONAL, preferably a DOCTOR. DO NOT trust your mental health to strangers on the internet, be it reddit, or hacker news, or whatever. If you are based in the US and live nearby a university they usually have good counseling services and the infrastructure to refer people even if you're not attending the school. Search "{school} counseling servic…

Some of the most depressing experiences I have had was to look for a therapist when I was really depressed. I went to several and never felt that they understood me or even cared about what I was thinking. I honestly think they made me worse.

I have learned way more useful info on online forums from people who were going through the same experience. Yes you have to be discerning but the advice “go to a professional” is thoughtless. There are a lot of incompetent people working in mental health. I am sure it’s easier if you have tons of money or just lucky to run into a good therapist. But already being down and then being disappointed by the professionals is devastating. At least it was for me.

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

#213
Medication helped me and probably saved my life.

I’ll put it this way: You’re already miserable, you don’t have much to lose.

People have horror stories and people have success stories it’s true, but even some of the people I’ve known with horror stories still found the end result to be positive/worthwhile.

Nothing is going to change if you do nothing and you’ll stay miserable. Alternatively you can do something and you may just improve your life.

I was at a colossal low point when I finally began to receive the mental healthcare I needed. It was worth it even though it took time to get the right medications for me.

Maybe you still feel like you have something more to lose than gain but I didn’t.

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

#214
post #119

Hey jpgvm, I've had depression ever since I hit puberty; and before, during, and after that: social anxiety. I've avoided anti-depressants for the first ~30+ years of my life. Eventually I decided I needed to try something, but wasn't ready for SSRI's and the bimodal data behind it. So about a year ago I decided to try St. John's Wort, which you can purchase without a prescription (in the USA). It can help manage mil…

No post body was provided.

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

#215
There are risks with taking any medication, so your concerns have merit. I take medications for depression, anxiety, and ADHD. I consider myself very lucky to have a very patient and supportive doctor. As I come on and off medications, we always talk about the risks and potential benefits. The choice that I have to make for myself is if the benefits outweigh the risks.

Another thing to consider is that while medications can improve your quality of life, they're only part of the solution. I see a therapist weekly and a coach for ADHD on and off throughout the year. I have to exercise regularly or else my anxiety and depression become unbearable. It's hard work, but I know that consequences of not doing those things are far worse. In my case, my medications don't solve my depression and anxiety. What they do is bring me up enough that I can keep moving forward and keep improving, with the hope that one day I will untangle the mess of emotions and I may not need them anymore.

You mentioned that you've tried therapy. Did you stop because you felt better or because you didn't have a good rapport with your therapist? This is just my experience, but it took 2-3 years before my therapist and I were able to tear down all of the defenses I put up for decades. I'm at year 7 and I'm finally starting to push through some of my own behaviors and stories I tell myself to make progress and take back control of parts of my life I thought I had no control over.

I can't tell you what you should do. What I will say with absolutely certainty is that it is not weakness to want help. It is not weak to want to live a productive life. I would talk to your doctor about what you're experiencing to have another opinion about your situation. Medication for some people is the complete answer, but that's not always the case. I would strongly encourage you to find a therapist that you have a good rapport with and stay with them. Once again, at least in my case, the medications balanced me enough to deal with my mental health issues. Dealing with depression takes a lot of time and energy, but now I know the issues I'm really fighting, I don't feel helpless anymore. Take care of yourself. You are worthy of having a good life.

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

#216
I have a friend who's had lifelong depression and had very good results from CBD after a couple of weeks of use. It was someone who hates meds and who I've been trying to get to take antidepressants for decades so it was quite a surprise to see them completely transformed by it.

Personally I've been depressed for as long as I remember and I've had incredible results from (medical) Ketamine. It was pretty much an overnight cure that lasted about 6 months. On the other hand CBD doesn't seem to be doing anything for me.

The thing to understand with heavy depression, and anti-depressants if you haven't taken them before, is that when your depression is chemically treated, it's like a veil is lifted from your mind. You suddenly are lucid, everything is no longer miserable and you didn't realize how truly miserable it was before. I would highly recommend you at least try something if it's been going on for as long as you remember and nothing else works. It's normal to be scared but give yourself a chance. It is transformative in ways you can't imagine.

If you seek medical advice, as would be wise, don't trust a single doctor, seek multiple opinions and take them with a large grain of salt, not as absolutes.

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

#217
When this comes up among friends I always ask, "If you had diabetes you'd take insulin right? Why is mental health any different?"

Find a psychiatrist and see them regularly so they can monitor your mood and response to the drugs. And stick with the therapy while doing this.

The combination is key, the meds will make getting through the day easier, and the therapy will help you find coping mechanisms and be more self aware of your emotions in a productive manner. This sounds hard and dumb but will be easier with the meds.

Then as you feel better you can work with both providers to adjust your meds or test removing them if that's something you want.

But at the end of the day, you need to talk with professionals. They're trained to help and will allow you to talk about specifics in ways that could identify triggers. Take it from someone with years of therapy and psychiatrist visits under my belt. It feels like it's not working at first, but you need to keep with it and follow through.

Good luck and I hope you find the help you're looking for.

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

#218

Earlier quoted context omitted.

I think the reason you are getting so many "I disagree" responses is because many of us have had awful experiences when it comes to medical professionals and mental health. It's important to understand the economic pressures in psychiatry. I went to see a psychiatrist, who prescribed me antidepressants. They helped give be a baseline level of energy to get me out of my acute depression, but they addressed none of my…

> I think the reason you are getting so many "I disagree" responses is because many of us have had awful experiences when it comes to medical professionals and mental health. > I've heard it said that giving antidepressants to a depressed person, without any therapy, is like giving amphetamines to a tired person: yes, they may temporarily cure your "tiredness", but what you really need is to go to sleep. I don't even…

I'm not glorifying Dr. Google, but I damn as hell am sure not going to take the "just shut up and listen to your doctor" advice.

Heck, I stated off the bat that antidepressants did help me. I'm not "anti-antidepressant" at all. But I do understand the economic forces at play means that plenty of "medical professionals" are more than happy to charge $200+ for a 20 minute meds management consultation, simply because it's faster/easier than dealing with underlying issues.

As for your "This whole thread should be booted waaaaay off HN" comment, the anger people are responding to is lots of us have had horrible experiences, but we're just told to "shut up and listen to your doctor". How do you think the whole opioid epidemic came about? Huge parts of the medical establishment were more than happy to get their commission, people's well-being be damned.

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

#219
step 1 - See a professional. It works for lots of people. It can work for you.

for me - I went the medication route and it didn't work for me. It may seem cringe but watching these videos changed my life.

https://www.youtube.com/watch?v=xt-cnPHBcBM

https://www.youtube.com/watch?v=Qv0oTrpFOPM

So for me the solution was

* exercise

* motorcycles

And after hanging out with other bikers I've learned a lot of people are dealing with issues.

Good luck on your journey!

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

#220
I don't remember where I read that but major depression should be treated the most aggressively way possible because each failed attempt makes the next attempt less likely to succeed. This will probably mean a combinationof therapy, exercise and antidepressant.

The cocktails described in Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications 4th Edition¹ are particularly effective but you absolutely need to be under the care of a psychiatrist to attempt that kind of treatment.

1) https://archive.org/details/stahlsessentialp0000stah

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