At 22 years old, after months long assessments, I have been diagnosed with severe ADHD, depression and moderate anxiety. Here is a quick timeline of my experience:

• May - August :
  • I started CBT therapy and Sertraline 50mg
  • Gradually I was upped to the a dose of 75mg.
  • In this whole period I did not experience any improvements or side effects, except a loss of appetite in the first few days.
• September:
  • I started taking Methylphenidate 18mg and went back to just 50mg of Sertraline.
  • From the first day I had felt a sentiment of calmness and control. But it slowly faded away and I still felt I could not concentrate on things or act productive.
  • I also stopped going to therapy as I saw that CBT was not effective for me.
• October - November:
  • This was a completely different month. I wasn't fully in control of my attention span but it was much better than I've ever been. What was more shocking was how internally I felt at peace and something that I'd describe now as euphoric (as I assume this was just a side effect of the medication). U
  • Until mid november I was actually going around telling people I think I might not be depressed anymore, as I had felt for the first time in a way that I haven't felt since early childhood. I was able to accomplish incredible feats related to discipline and I saw my academic results improving greatly. Unfortunately this sentiment slowly faded away and I was back to my old self by the end of November.
• December - Now I was upped to 36mg of Methylphenidate and I noticed a much better control of my attention but unfortunately I have not felt that feeling of relief again. And as it seems the effectiveness of the dose diminished from the first few days to now.
  Since December I've had numerous breakdowns, feeling completely exhausted and burnt out. I suffered from classic problems of procrastination starting to work on difficult projects only a couple of days before the deadline and it was all crashing down. I submitted multiple disgustingly low quality pieces of work because I just did not work in time enough but the few days I did work I did incredible amounts of effort and I do feel like the pills helped me stay focused. After this deadline period though I was just met with my normal depression symptoms where I had a long streak of days that I could not even get out of bed or brush my teeth.

I don't know what more to do. I always knew I was broken and needed help. And for all my life I thought that seeing a psychiatrist is a last resort in case "I can't fix myself" on my own. Now it's been almost a whole year and I am in a critical time period where I need to excel and put in the work but I find myself succumbing to my symptoms while jumping up and down with the doses of some pills that barely seem to have an effect.

I didn't have many people around me from the start, and many of them would not understand my condition at all (nobody from my family does). But now it seems that even the few that were empathetic I have unfortunately tired out. I've heard my fair share of bad remarks that have gradually demoralised me (ADHD is not real. I'm just lazy. I just like to complain. etc) and due to the fact that I also have codependency problems this has greatly hurt me and made me feel like I am completely alone and nobody cares for my troubles or has my wellbeing in their best interest. Right now I just wish I'd know what to do. I wish there was some clear step by step goal oriented way to "happiness" or at least normality. I don't even know what more to tell my psychiatrist other than how I don't feel well, which is what I've been telling him since the start.

If you've been through a similar journey, I'd love to hear your experience and any advice you wish you had received earlier.

Traumatic brain injury multiplies the risk of major depression eightfold. While the emotional trauma of whatever caused such deep damage may be understandable, from a blast in a war zone to a blow on the playing field, there’s a physiological component, too, that neuroscientists have long suspected but have been unable to identify.

“As clinicians, a lot of us had a gut feeling that [TBI-associated depression] is a different disease,” said Shan Siddiqi, a Harvard Medical School assistant professor of psychiatry and a clinical neuropsychiatrist at Brigham and Women’s Hospital in Boston. “Why did nobody detect it before? I think the reason is because unlike other psychiatric disorders, TBI caused a sort of structural reorganization of the brain.”

https://www.statnews.com/2023/07/06/depression-after-traumatic-brain-injury/

I have a very close friend that has been in the deepest troughs of depression for the past couple of years. They live about an hour away, so though my wife and I try to physically show up to support them whenever we can, that's much less often than we'd like. Their support network is thin, and day-to-day basically consists of only their partner, with whom they live, and who is visibly fraying at the seams.

This person (I'll just call them John for the sake of readability) is currently on medication for their depression and OCD (I'm nearly certain it's Lexapro, can't remember for sure) and has on and off therapy, though they often find themselves at odds with their therapists' perspectives. Some of this is because it feels like the profession has been flooded with folks who lack experience with patients with severe chronic mental illness, and some of this is (I suspect) John's illness distorting their thinking, leading to frustration and anger in the moment that doesn't make sense in retrospect.

John had a particularly bad day yesterday, and after I spent some time with them, we started talking about how they felt like they needed considerably more support than they were able to get in their current situation. Unfortunately, the only option he was aware of was "group homes", which seems like a pretty broad term and I don't know much about what they look like (or how successful they are at helping people like John).

I'm trying to get a sense of the spectrum of options available for people like John who are suffering from severe chronic mental illness. On the one end, there's what we're doing now; regular psychiatry and counseling, and on the other end, I guess, is involuntary in-patient behavioral health/medicine clinics. Being involuntarily committed to such programs has been a source of trauma for them in the past, so I'd like to avoid anything even close to that end of the spectrum, if possible. I know that there are, for example, 90-day rehabilitation centers for folks with substance use disorders (I have a family member that found a lot of success at one of these), but do similar programs exist for folks non-substance-related mental illness? Does anyone have personal experience with any of these programs?

Thanks in advance to anyone who takes a moment to read and share their thoughts; I know this is a really challenging topic.

Insight once came to me after I was prepped for a surgical procedure. As my body's weight began to evaporate, a pain I had never recognized, but which must have always been sounding in the background noise of my being, vanished. The superadhesive worry--which sometimes frightened others as much as myself, that in order to socialize, I had learned to sometimes twist into a temporary shape resembling charm--came unstuck and peeled away. Then followed a great thought, a mandate for how I should spend the remainder of my life. Also, I needed to poop. But more than that, I needed to get out of this semi-public hospital bed and to a private space immediately, so I could allow this cosmic insight a moment to fully bloom. Time was against me. Anesthetized, I knew I was slipping toward, maybe even over, the falls past which I would forget everything of this experience until a groggy post-procedure awakening brought dull daylight and its senseless aches back to me. I had to somehow save the thought. I searched, but the bathroom gave up no markers, no specimen cup labels to write on. I wondered about tearing toilet paper into little letters, hiding them above the cabinet. But would I remember to return to read the message? With an increasingly calm desperation, I dug my nails into the flesh of my hand and repeated again and again the life-saving insight delivered during communion with the world that lay beyond pain. Please remember, please remember this thought.

When I regained consciousness, it was waiting for me like a friend who had lost patience, and now seemed much less attractive. What I had somehow stolen from the gods, secreted in my closed palm through a swim across the river Lethe, was this message: “Do Drugs.”

I had realized that analysis, working on the problem of myself both mentally and verbally, had won me no appreciable gains. Insight, I had. But relief, happiness, an improved outlook? Nothing I had done had really helped me feel better. Anesthesia instantly had. These aren’t the words of an addict coming on-line. I was a reluctant user of any substance. However, in the years following I forced myself to again undertake drug trials with my psychiatrists. Methodically, I worked through every class, waltzed backward through the eras of drugs, danced off-label with each oddball wallflower, ingested every twisted molecule to ever win over the FDA with a promise of psychiatric benefit and maybe some that merely had intrigued one of my more historically-curious doctors. When Eddie Haskell, MD wanted to resurrect a drug of the bad old days just to see what it’d do to a person, I was the patient with his hand out.

I overslept and didn’t sleep. I gained and lost a third of my body weight. My head felt like a styrofoam block, then like the slate of a blackboard being scraped with tableware. I was more or less charged, sweaty, sensitive to light, and shaky. Some drugs make you feel like Benjamin Braddock in his birthday diving suit. Others make you feel like an amnesiac idiot in Benjamin Braddock’s birthday diving suit. A common theme emerges. These substances could help me feel slower, distant from the world, claustrophobic, clammy, sensorily distorted. Sometimes, they dulled my anxiety, or dried my hair-trigger tear ducts, but they accomplished this through impairment, and very clumsily. I have never been drunk, but I think it’s like a drunk traffic cop: success in psych meds comes about by the stopping of certain avenues, slowing up of traffic, blocking lawful turns. And it’s sometimes noted in the overall impact that fewer crashes have occurred. To me this is not success. Impairment so far hasn't been healing for me. I want my turn at quoting the line, "I feel like myself again."

And so, my heart sinks at every day's new headline about psychedelics. If you follow health news at all, you know they are a hot topic, showing a ridiculous amount of promise. Despite fitting the diagnostic profile, my former home was far from anywhere with signups for studies. I reached out to several "clinics" offering psychedelic-assisted therapy. They struck me as resembling many legal weed shops--loads of young bros polishing their presentation and sanitizing an extortionate drug deal in hopes of financing a Tesla. With fees starting at 8x the plane ticket to administer and contextualize a drug that costs less than $20 a dose, I wouldn't credit their soft patter as containing much idealism.

And here I am--for other reasons besides. Yes, a part of me thought living here would put legal psychedelics within my reach, but I'm not seeing any opportunities. Now I'm kicking myself for never having tried to cultivate mushroom spores, never having ventured to ask acquaintances for a hand. I'm marooned here and psilocybin is about blow up in the States.

Hello everyone,

I recently got put on some SSRI for my worsening suicidal ideation and honestly I can't believe the difference it's made. It's like a version of myself that I find hard to believe existed, but can draw parallels with the version of me before I got depressed, etc.

I'm just curious how I should be viewing these changes in me: Are they really me without depression/anxiety or is it a more lurid exaggerated version of that?

Any other thoughts on SSRIs in general welcome! I'm interested in seeing Tildians' thoughts on them :)

Hello,

So I've been officially diagnosed with depression a few years ago. I am on medication for it and I've done therapy in the past. I am a more functional person than I was, let's say, one year ago as I've adjusted my medication.

However there is something that is SEVERELY affecting my quality of life and that is the generalized lack of interest or extreme difficulty in doing almost anything. Yes I've talked with my doctor about this. It's "normal" and we are working on it.

I don't know many people and COVID-19 took a hit on my already limited social life. So I guess I want to share my experience and hear from others who experience(ed) the same difficulties. When you are trapped in not wanting to do anything, what the hell do you do?

Recently I've started reading a physical book again. I think it is a good thing for me to have something to do that does not involve a screen. Plus it makes me sleepy if I am a bit tired which, for me personally, is great. Aside from this next experiment, the activities I do the most are playing one or two video games, study for my degree and work part-time.

Another thing I've started doing is doing the bare minimum in terms of physical exercise. I am working on doing pull-ups (I went from doing 0 to 1,5 =) ) and doing some squats. School and work rob me of a lot of energy so I tend not to exercise. But now I'm trying to at least do something.

I will try to keep up with this post but I have a tendency to procrastinate on them if I get a lot of replies. Thanks for bearing with me =).