Comment by mirimir | Hacker News Reader

Comment by mirimir | Hacker News Reader

That brings back horrible memories. I took an SSRI for several years, initially prescribed by a GP. But the problem was that I wasn't "depressed". I am bipolar, and sometimes got stuck in down mode.

The SSRI did make me more functional. But what it mostly did was make me affectless. That is, I could be sad or happy or angry or whatever, and I felt pretty much nothing. However, I still did whatever someone who was sad or happy or angry or whatever would do. You could say that it made me sociopathic. But fortunately, not homicidal or suicidal. Or at least, not in a big way. Also, I lost interest in sex, and it took forever to reach orgasm.

And yes, quitting was painful. Mostly I recall restless leg syndrome. I would kick my partner while asleep. And I got even crazier for a while, as I tapered off.

So now I'm taking modafinil and lamotrigine. Which works very well for me. I'm a little manic most of the time, but I like that. And I'm not at all sociopathic.

> Also, I lost interest in sex, and it took forever to reach orgasm.

This is a common side effect of SSRIs. I have the same, but I very much enjoy that side effect. Saves time, and already got a child anyway. I still love pleasuring my significant other just as much as before, btw.

People who have bi-polar usually get mood stabilisers such as lithium prescribed. Perhaps anti-psychotics? SSRIs are known to be problematic for bi-polar personality disorder.

Lithium sucks, or so I've heard.

Modafinil (antinarcoleptic, originally) plus lamotrigine (anticonvulsant, originally) works well for me. It's easy to tweak the ratio as circumstances warrant.

Edit: About sex. My wife at the time did like that I took longer to reach orgasm. However, after we separated, I discovered that wearing a condom made orgasm unreachable. And that did become a problem. Albeit an amusing one, in retrospect.

Nice to see modafinil getting a mention. I've found it to be near-miraculous as a fast acting antidepressant that helps combat the cognitive downsides of other meds.

I used it for sleep apnea tiredness. It seemed basically like caffeine.

I had and still have this issue. Most women are down for a 3 hour sexathon needing a gatorade half way through. Try no porn, no fap and less sex.

Don’t discount lithium, it may turn out better than modafinil for you.

I've been using that mix for several years. And I'm not interested in changing.

But why do you say "better"?

Midafinil fights effects of poor sleep. Lithium may stabilize the mood swings that disrupt sleep in the first place.

It's lamictal that stabilizes the mood swings. And modafinil adjusts the set point.

Interesting - I have bipolar too (that is, bipolar II), also misdiagnosed as pure depression for a while. However, the SSRI didn't flatten my affect, but instead amplified my hypomania to where it was severe enough to be diagnosed. Now I'm on lamotrigine and sertraline, and the two together keep me stable and up.

How did you end up getting properly diagnosed for Bipolar disorder? I'm currently taking antidepressants after battling SOME kind of mental illness for most of my adult life. I'm really inside my head, and often have very existential, self-doubting moods, to the point where I have burned a lot of bridges (jobs, friends, relationships) with antisocial behaviour (that I would never logically think is the right thing to do), but in the right mood, having also tried MDMA, I act completely normal, can hold conversations, etc. (but that's once in a blue moon normally).

I found a psychiatrist who asked me whether amphetamines made me happy or nervous. I said happy. He said bipolar.

I was in weekly talk therapy with a psychologist and checking up with a psychiatrist every few weeks to fine-tune my meds, the two were in close contact, and one of them (don't remember which) picked up on my periodic euphoria and social extroversion.

Hmmm. I suppose that I was hypermanic. And maybe it wasn't so much that I was affectless, but that it wasn't appropriate affect.

OK, for example, I would be driving, in a hurry. And without much emotion or warning, I'd find myself running red lights and whatever. Laughing. I remember an accident, where the other driver said something like "Where the hell did you come from?" And I almost said something like "God sent me to kill you!" But I didn't, fortunately.

That SSRI truly made me a danger to society and myself.

Ooooh. Yeah, that's definitely full-blown mania. Delusions of grandeur, risk-seeking behavior, euphoria.

Well, there really wasn't much euphoria, as I recall. More stoic cynicism.

I like to say a little on the manic side. I feel more alive. But not too much, because it's bad for me. Now I can just be happy and energetic.

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