All depends on what you think is worth it. Things might have turned out better if I didn't do things. I can't fix that. But either way, the "worst possible outcome" has been prevented.
Update on Medicine/My Side. The man who screened me agreed that I have a Mild to Moderate Form of Inattentive ADHD. He believed my feelings of depression or mood swings or anxiety can be associated with ADHD as a whole. I went to my doctor and she gave me a prescription for Methylphenidate/Ritalin/Concerta for about a month. I started taking it Thursday with a single 5mg pill each day and Sunday it bumped up to two 5mgs pills until they run out.
My ability to focus and sleep consistently has definitely increased. I am more productive writing and cooking and more physically active. However my attitude and depression hasn't changed much. Whenever physical pain interacts with my mental pain, I still find it crippling at times to do the right things. So the change as a whole is for the better, but still not 100%. Maybe in a few weeks time I'll feel truly better, but the process is definitely difficult.
I can only speak to the attention/work ethic effects of Methylphenidate, because that's what I take it for, but it's a pretty great drug. I'd just recommend checking out a forum or similar resource and read about other people's experiences with it. In my case at least, having been medicated since I was 7 or so, I was never told much about the drugs I was taking. Then in college I spent a weekend reading everything I could find, from Wikipedia articles to ADD forums to discussions between recreational users, and it gave me a new perspective.
The one specific piece of advice I'll give is that the attention effect tends to be subtle. It won't sit your ass in a chair and open a text book, but it'll help keep you from getting distracted by your phone 20 minutes in.
I was told some pretty outstandingly offensive shit about my depression by one of my closest friends last night. Wish I still had the thread to pull quotes from, but whatever. The jist of it was that I'm a drug addict for treating my condition with mood stabilizers and coffee, and someday I'm going to have to give those up to face "the root of [my] depression". I tried to explain to him that people who faced the root of their depression were folks like Robbin Williams, Hunter S Thompson, Kurt Cobain, and Brian Epstein, but he was having none of it.
Fortunately he leaves for college out of state on Friday, and doesn't plan on coming home for the holidays, so I never have to talk to him again if I don't want to.
Sounds like a misguided person who thinks all chemicals are bad. I wouldn't right them off as a friend, but no need to make a great effort to stay in touch. They might come back from college completely different and much smarter.
Friends who think they're being helpful when they're actually being ignorant and judgmental.. that's a tough thing. Especially if you sympathize with the former while being repulsed by the latter.
A good friend will not leap to judgment, though. It sounds like his mind is made up about a subjective experience he's never had, and that's... butt.
I was prescribed Vyvanse last week. There was some concern that it would exacerbate my anxiety, but so far it has smoothed it out. Seems like a big part of my issue was being unable to focus on an anxious thought long enough to bring it to a conclusion and move on. I also used to think I had social anxiety, but now that I can focus I have a strong motivation to socialize and I can have a conversation without jumping ten logical steps sideways in the middle. To top it all off, video games are even more fun on amphetamines. Better living through chemistry!
Another friend has taken up arms with me being on meds. David says its a cultural thing -- they're both Hispanic, and he says Hispanics don't believe in mental illness.
Out of curiosity, and in comparison to the UK, how much support is there once you have been diagnosed with depression and the like. Is there counselling on offer or support groups? I ask as most of the time I see people talking of how they are on meds but nothing more, it is an interesting to the UK which is very much against prescriptions and places more of an emphasis on counselling.
Most doctors I've encountered insist on regular therapy to supplement SSRIs, which I think is a little too cookie cutter. Not everybody needs counseling. Some people just need a little tweak to their chemistry to stay level and avoid the crashes.
Counseling where necessary is essential, but a blanket requirement I think will keep people with a mild but real need from even using the treatments available.
I think part of the issue is that there certainly seems to be a debate as to whether counseling or medication is the best treatment for depression, especially for mild cases. Me, personally, I'm in the counseling is always the first option camp with only turning to medication if things start getting more severe.
I've been seeing a counselor since before I was on psych meds, or even diagnosed with any psychiatric disorder. I don't know/remember what initiated it, but my dad was like "you need to see a counselor, this guy looks pretty good" and we just kinda went from there. He hasn't been as helpful with my condition as meds are, but he's helped me with a lot of other problems in my life. He also was the one who told us about the residential program at McLean's, which turned out to be very useful.
That's the thing... depression is a complicated interaction of all sorts of factors, including brain chemistry and external emotional stressors. The meds can help with the brain chemistry part, but they don't do much for the emotional stressors. At best, the modified brain chemistry can "paper over" (for lack of a better term) the stressors, but they do not address the root problems.
Each case of depression is different. With some, brain chemistry is the primary cause, and meds are the best way to handle it. With others, it's the emotional stressors that are the primary cause, and meds won't solve the root cause of their problems. With others, there is probably a mix of the two going on and both types of therapy are necessary to treat the condition.
The fact is, even if meds help you with your brain chemistry-caused depression, they won't necessarily help you with other problems in your life, many of which can contribute to making the depression worse. Depression is something which I feel truly needs a holistic treatment approach.
I'm speaking as someone where the issues are primary about emotional stressors and counseling is about the one thing that works for me. The one time I was on medication, it was only for about 6 months, and it was mostly because I was hit by a whammy of issues pretty much simultaneously that I needed a little something extra to get over that hump. I realized that medication wasn't the right thing for me, at least long term, because when a certain tragedy happened in my life when I was on the meds, I just felt kind of numb about it instead of feeling any true sadness.
I think part of the issue is that there certainly seems to be a debate as to whether counseling or medication is the best treatment for depression, especially for mild cases. Me, personally, I'm in the counseling is always the first option camp with only turning to medication if things start getting more severe.
I'm in the "try all the things and see what works" camp. This shit is complex, so it would be naïve to expect an easy solution.
It really interesting the lack of discussion on brain chemistry. In the UK, or at least in my dealings and with talking to others, there is a greater emphasis placed upon counselling and developing ways to help yourself if you suffer a low patch. A lot of the people and or doctors that I have spoken too say that their end goal is to be medication free for the person.
It really interesting the lack of discussion on brain chemistry. In the UK, or at least in my dealings and with talking to others, there is a greater emphasis placed upon counselling and developing ways to help yourself if you suffer a low patch. A lot of the people and or doctors that I have spoken too say that their end goal is to be medication free for the person.
That is the end goal for a lot of doctors, though it probably varies based on the person.
Let's take two kinds of mental health doctors: psychiatrists, who are medical doctors who can prescribe medications, and clinical psychologists, who have PhDs in psychology, but cannot prescribe medications and therefore are limited to counseling. The trade-off for the clinical psychologists is that they have much more training, expertise, and knowledge in how the mind works (i.e. psychology, as opposed to the physical brain chemistry), hence they are superior counselors than a psychiatrist would be as they often have relatively limited psychological knowledge but presumably know all there is to know about what the chemicals in your brain are up to. Non-PhD counselors would be in a similar category to PhD clinical psychologists in that they'd have more expertise in psychology (though not as much as the PhDs) than the psychiatrists.
Now, as for me personally, I think one should probably start off with the counseling approach for depression unless either:
You are so depressed that you are likely to cause physical harm to yourself or others, in which case it's appropriate to do everything possible to stabilize the situation before then trying to determine what the actual root cause and appropriate treatment would be.
You honestly have no idea why you're depressed... i.e. nothing emotionally stressful or traumatic has occurred to you recently that could be messing you up in the head.
The reasons why I prefer starting with counseling outside of those two scenarios are two-fold:
Medications have various side-effects, therefore it's best to avoid using them unless they are absolutely necessary. This is especially important with depression-related medications as they may often worsen the symptoms of depression during their early treatment phases.
A knowledgeable counselor would be able to recognize situations where counseling is insufficient/ineffective and would, without hesitation, recommend seeing a psychiatrist for appropriate treatment with medication.
Similarly, a good psychiatrist would recognize the need for psychological counseling and either refer you to a counselor for that aspect of the treatment or work as a team with your existing counselor. The goal with an initial meeting with one or the other is to determine the best course of treatment for you and to at least get some semblance of why you're depressed to begin with. If you've started feeling depressed after your dog died, your grandmother died, and your significant other left you, then odds are your problems are mostly psychological and medication probably isn't going to be the ideal long-term treatment for you. If, however, you're feeling depressed for no apparent reason, then it's much more likely that you're chemically imbalanced and medication is probably more appropriate than counseling.
I suspect that (partially based on my own personal experiences), for the majority of people with depression, they spend some or all of their time in the middle of "purely psychological" and "purely chemical" and therefore would benefit from some form of counseling, whether or not the chemical factors necessitate the need for medication.
I'm firmly in the "it's not such a radical theory that I'm just short a little chemistry" camp. I won't sit through tedious and condescending therapy sessions for a low dose SSRI that would level me out, so I just eschew both.
My neighbor shot a squirrel yesterday. I just found it heaving in our garden fighting off flies. It can barely walk in a circle and I can't find an open veterinary hospital.
Comments
My ability to focus and sleep consistently has definitely increased. I am more productive writing and cooking and more physically active. However my attitude and depression hasn't changed much. Whenever physical pain interacts with my mental pain, I still find it crippling at times to do the right things. So the change as a whole is for the better, but still not 100%. Maybe in a few weeks time I'll feel truly better, but the process is definitely difficult.
The one specific piece of advice I'll give is that the attention effect tends to be subtle. It won't sit your ass in a chair and open a text book, but it'll help keep you from getting distracted by your phone 20 minutes in.
Fortunately he leaves for college out of state on Friday, and doesn't plan on coming home for the holidays, so I never have to talk to him again if I don't want to.
Your "friend" is a dick and you're better off without him.
WHAT DO YOU SEE?
That next book needs to come out.
Friends who think they're being helpful when they're actually being ignorant and judgmental.. that's a tough thing. Especially if you sympathize with the former while being repulsed by the latter.
A good friend will not leap to judgment, though. It sounds like his mind is made up about a subjective experience he's never had, and that's... butt.
You're a cool dude, Greg. Cool dudes (and dudettes) shouldn't have to deal with stupid drama.
Counseling where necessary is essential, but a blanket requirement I think will keep people with a mild but real need from even using the treatments available.
Each case of depression is different. With some, brain chemistry is the primary cause, and meds are the best way to handle it. With others, it's the emotional stressors that are the primary cause, and meds won't solve the root cause of their problems. With others, there is probably a mix of the two going on and both types of therapy are necessary to treat the condition.
The fact is, even if meds help you with your brain chemistry-caused depression, they won't necessarily help you with other problems in your life, many of which can contribute to making the depression worse. Depression is something which I feel truly needs a holistic treatment approach.
I'm speaking as someone where the issues are primary about emotional stressors and counseling is about the one thing that works for me. The one time I was on medication, it was only for about 6 months, and it was mostly because I was hit by a whammy of issues pretty much simultaneously that I needed a little something extra to get over that hump. I realized that medication wasn't the right thing for me, at least long term, because when a certain tragedy happened in my life when I was on the meds, I just felt kind of numb about it instead of feeling any true sadness.
Let's take two kinds of mental health doctors: psychiatrists, who are medical doctors who can prescribe medications, and clinical psychologists, who have PhDs in psychology, but cannot prescribe medications and therefore are limited to counseling. The trade-off for the clinical psychologists is that they have much more training, expertise, and knowledge in how the mind works (i.e. psychology, as opposed to the physical brain chemistry), hence they are superior counselors than a psychiatrist would be as they often have relatively limited psychological knowledge but presumably know all there is to know about what the chemicals in your brain are up to. Non-PhD counselors would be in a similar category to PhD clinical psychologists in that they'd have more expertise in psychology (though not as much as the PhDs) than the psychiatrists.
Now, as for me personally, I think one should probably start off with the counseling approach for depression unless either:
- You are so depressed that you are likely to cause physical harm to yourself or others, in which case it's appropriate to do everything possible to stabilize the situation before then trying to determine what the actual root cause and appropriate treatment would be.
- You honestly have no idea why you're depressed... i.e. nothing emotionally stressful or traumatic has occurred to you recently that could be messing you up in the head.
The reasons why I prefer starting with counseling outside of those two scenarios are two-fold:- Medications have various side-effects, therefore it's best to avoid using them unless they are absolutely necessary. This is especially important with depression-related medications as they may often worsen the symptoms of depression during their early treatment phases.
- A knowledgeable counselor would be able to recognize situations where counseling is insufficient/ineffective and would, without hesitation, recommend seeing a psychiatrist for appropriate treatment with medication.
Similarly, a good psychiatrist would recognize the need for psychological counseling and either refer you to a counselor for that aspect of the treatment or work as a team with your existing counselor. The goal with an initial meeting with one or the other is to determine the best course of treatment for you and to at least get some semblance of why you're depressed to begin with. If you've started feeling depressed after your dog died, your grandmother died, and your significant other left you, then odds are your problems are mostly psychological and medication probably isn't going to be the ideal long-term treatment for you. If, however, you're feeling depressed for no apparent reason, then it's much more likely that you're chemically imbalanced and medication is probably more appropriate than counseling.I suspect that (partially based on my own personal experiences), for the majority of people with depression, they spend some or all of their time in the middle of "purely psychological" and "purely chemical" and therefore would benefit from some form of counseling, whether or not the chemical factors necessitate the need for medication.