2013-02-20 06:41 pm (UTC)
As an internet doctor, and someone who has also tried fluoxetine: Congratulations, it sounds like you're having a better experience because of the medication. Hooray and other good news sounds.
(Fwiw The dangerous SSRI is normally seroxat, not fluoxetine. Citalapram apparently has milder effects. Personally, Prozac made me hypomanic)
> I had to get to a very low point before I decided that however bad the drugs were they had to be an improvement; in retrospect I put myself through years of suffering needlessly.
Although the drugs are helping, do you think this logic applies to other things you are doing in your life? Are there other improvements or changes you've been considering, but putting off due to a plethora of negative thoughts?
>The first thing to explain is that fluoxetine didn't take away the negative thoughts or the self-loathing. What it did was to stop me caring about them. It may not sound like it, but this was a huge improvement.
It's a huge improvement. Being able to handle negative thoughts without being overwhelmed is a fantastic step in the right direction.
> it also gave me the emotional space to recognise that the negative thoughts were symptoms rather than accurate reflections of reality¹, and to learn and practice techniques for dealing with them. [[This, incidentally, is part of the reason I get upset when people start complaining about people who aren't present: it makes me wonder what terrible things they're saying about me when I'm not around. ]]
Fwiw I do not think you are a terrible person, not even for your choices in programming language. I guarantee you someone with long term depression will always have lower and more destructive opinions of themselves than their friends do of them. It doesn't mean you're the best, or a utopian creature, but it is hard to be reflective without losing some semblance of balance and objectivity.
As for people talking behind your back. If they're being negative in front of you, that means they trust you, and can get away with saying things that would be hard to talk about openly—like problems with jobs, doctors, coworkers, friends. If they're being negative behind your back, well, generally those people rarely talk to you in the first place. It's a bit of the classic geek social fallacies of rejecting social ostracisers. Social groups often have a common antagonist over a common cause.
2013-02-20 06:42 pm (UTC)
> Annoyingly it hasn't made me as functional as I'd hoped, [...but ] barely-functional and meh is, I repeat, a huge improvement over barely-functional and miserable. And I am more functional: [...] No way could I have done any of those things a year ago. Side effects: there have been a few, mostly pretty mild.
For some, medications are a good treatment for depression, and in some cases the best solution in the long term. I don't think it sounds like a good time to worry about if they are the right choice in the long term for you yet, but certainly in the short term, it sounds fantastic. Don't worry about the long term, see how you feel later on about things, especially if the side effects change, or become frustrating.
> Of possibly more concern is what Johann Hari calls "antidepression": a pervading sense that things don't really matter, which leads you to take unnecessary risks and get yourself into trouble.
A sort of nihilistic fuelled hedonism is fun, but as an internet doctor i'd consider it similar to hypomania. For me, SSRIs made me take risks, and still come home in tears. It doesn't like you've gotten close to that stage, as really, paying credit cards bills a bit late and setting up doesn't sound like you're being too self destructive. Worth keeping in check.
As you've said, prozac helps with the depression, but it doesn't make it go away. You're going to have to introduce new structures and habits to effectively manage depression.
> the "I'm barely holding my shit together here, it can wait" excuse is wearing increasingly thin.
It can wait, although it is hard to make this call without some context. Depression for some, is not something you snap out of after a few months, or a few years, and can be something you will be dealing with for the rest of your life. You still have a sizeable proportion of your working life ahead of you, so putting somethings off in the short term won't undermine the rest of your life.
You're still beating yourself up, and then beating yourself up because of it. Paralysed by feelings of uselessness, uncertainty and low self confidence, you avoid opportunities. Then you make yourself feel worse for giving into the depression. This is a bit of a cycle that is hard to break. You're not a calvinist, You don't have to burden yourself with every mistake you make or chance you didn't take.
> This post may be one such. But a year ago I'd have started writing it, decided that the whole thing was shamefully narcissistic, that I was an Awful Person for thinking anyone would care about this stuff when there are people out there with Real Problems, Dammit and abandon it half-finished in a depressive spiral.
Post seems ok, mostly about your experiences, without trivialising, or dictating others experiences. It sounds like prozac has been a good choice for you.
> This post lacks a conclusion. Sorry about that. But I don't particularly care.
It has no conclusion, but then again your treatment for depression isn't over yet.
I think if you keep on it, and the cognitive behavioural trailing—realising when you're spiralling and not getting sucked in with your thoughts—Things will keep improving, although things won't be perfect. You'll still take some risks, avoid others, feel a bit shit now and then and second guess the motives of the people around you, but you won't be overwhelmed by life as much.
2013-02-20 06:44 pm (UTC)
tl;dr depression is terrible, you're not, glad the meds are working out, but keep working on your sad brains, it takes time.
You're still beating yourself up, and then beating yourself up because of it.
Wow. Yeah. This is me too. So often it's almost painful to think about.
Third-level beating yourself up!
> A sort of nihilistic fuelled hedonism is fun, but as an internet doctor i'd consider it similar to hypomania.
*Googles hypomanic symptoms*
Nope, I don't think I've ever felt like that. Well, possibly during Edinburgh Fringe rehearsal weeks, which are basically ALL GO ALL THE TIME with fun people all around you. So I think we can write that off as situational. I'll watch out for hypomania, though: thanks!
> Paralysed by feelings of uselessness, uncertainty and low self confidence, you avoid opportunities. Then you make yourself feel worse for giving into the depression.
Oh hell yes, this is exactly what depression does to me.
> It has no conclusion, but then again your treatment for depression isn't over yet.
Good point :-)
> It can wait, although it is hard to make this call without some context.
The context is that my current contract runs out in April 2014, and that allowing a year to find a new academic job is, if anything, cutting it fine. Not that I particularly *want* another academic job, but academia is at least preferable to not having a job at all. And if I want an academic job (or even something to put on my CV to explain what the hell I've been doing for the last three years) I need publications, and if I want to get publications I need to do some research, and... I'm sure you see how this is going.
Thanks very much for such detailed feedback!
> Are there other improvements or changes you've been considering, but putting off due to a plethora of negative thoughts?
Hmmm, good question. The obvious one is choice of job: I applied for a non-academic coding job recently, but should probably apply for more. A bigger step would be leaving the computer industry entirely; not sure if that's such a great idea, especially while I'm my household's main breadwinner.
> I do not think you are a terrible person, not even for your choices in programming language.
Heh :-) The last language I wrote code in was Scheme, does that help?
> If they're being negative in front of you, that means they trust you
Huh, so I misread that kind of situation entirely. How interesting. It still seems a rather distasteful way of bonding, IMHO.
Edited at 2014-05-28 06:30 pm (UTC)