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Comment by DougN7 | Hacker News Reader

This actually sounds quite a bit like depression. Some inexpensive meds can make a huge difference. I know from experience.

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I have tried prozac. Unfortunately, it made my tiredness even worse almost immediately. Doctor said this would go away after I increased dosage, but I couldn't stick with it long enough to see this benefit.

I've considered trying again but, it's a hard pill to swallow when the solution takes weeks to work, and in the meantime, you're suffering even more.

If I had to be honest, I question whether I am scientifically "depressed". The "tests" they give you are totally subjective.

While, yes, I exhibit many of the symptoms of depression I also wonder if I'm just ill suited for modern life. My interests are strong, and fleeting. Life seems to reward people who can hold focus on boring tasks, for long periods of time, even decades. I was probably a better hunter than I am a programmer.

Yet, here I am, coding for a living and browsing the internet in my spare time. Oof.

So get out there! I hear you say. Yea, if only it were so easy to uproot my entire life, leave my wife, and go live wild in the sticks where I'd be more centered and at peace with my core being. That's just not feasible.

The point isn't that I would be happier living in the woods, off the grid, in the rawness of nature ... The point is just that something in this modern life is missing, and more likely than a chemical imbalance, it is that missing element which drains my soul and leaves me exhausted and unmotivated.

That, or it's some terrible undiagnosed medical condition.

> My interests are strong, and fleeting. Life seems to reward people who can hold focus on boring tasks, for long periods of time, even decades. I was probably a better hunter than I am a programmer.

Sounds like ADHD.

Programming can be good for ADHD though, since it has strong short feedback loops.

i'm not sure if you are still interested in pursuing a pharmacological route but SSRI's are some of the least effective anti-depressants available today. many meta-reviews have pegged them as not better in a statistically significant way than the placebo.

if you're willing to still give it a shot, see if your doctor is willing to prescribe tricyclic antidepressants or MAO-I's. mao-i's in particular are very effective but come with some dietary restrictions (certain cheese and fermented foods are off the table).

>That, or it's some terrible undiagnosed medical condition.

Sounds like ADHD to me too. At least it's eerily similar to my experience and I'm in the process of getting diagnosed.

https://youtu.be/WFkpICWE9DM - might help.

So, probably, yes.

I have struggled my entire life with these issues. The post you see here isn't something that's new.

Whatever is causing this is inherent to my being.

I've seen doctors, and had both depression and adhd diagnosed. The ADHD meds were amazing. They "solved" this problem. I feel better, I feel happy, I feel more motivated, I feel more natural interest and ability to hold my focus. I feel less foggy and tired.

But, I can't stomach being on stimulants my entire life. I hate that idea.

So yea, the one thing that works, I'm not willing to take. Hard to have much sympathy for me if I'm not even willing to take what is being prescribed.

I keep saying to myself I need to just man up, and take the medicine. I do it for a week, I feel great, and then I start to hate feeling different (even if different, is quite good), and I attribute it to being loaded with amphetamines, and how bad that must be for my body.

So I stop taking them and revert to feeling shitty and looking for a new solution.

> and how bad that must be for my body.

For what is worth, at prescription doses they are not bad for your body at all.

You have my sympathy regardless, for whatever it's worth.

I don't yet have access to stimulants (beyond caffeine), but I've found cannabis relieves the ADHD symptoms when used sparingly (A very short hit from a vape, essentially microdosing).

Even still, I'm on a 4:2 cycle. 4 days medicated, 2 days off, because I find myself feeling stretched thin if I remain medicated for too long.

This fucked up brain of ours just doesn't belong in this fucked up world of ours. Do whatever you need to do to cope.

You might want to just try a lower dose. While it may be different because I don’t take stimulants for ADHD, I don’t feel like myself if the dose is too high.

Also, different medications work for different people. Vyvanse works the best for me, but I’m just after stimulation (for idiopathic hypersomnia).

I've struggled, and am struggling, with the same thing. The only thing that helps me is to keep doing... something.

Also, talk to your wife about changing lifestyles if you haven't already. She might surprise you.

That sounds exactly what I was going through for the past 15+ years. I had many strong interests, but everything seemed like more work than it was worth doing. Depression and anxiety accompanied the low motivation. I chalked it up to being in a bad mood, and tried lots of mental health related things to fix that, with little progress over years of consistent effort.

Within the past two or three years, some health concerns started showing up - daily headaches, a near-constant lightheaded feeling, nausea, trouble focusing my eyes, stuff like that. Eventually, the near-constant nausea forced me to try some dietary changes.

It turned out that gluten was the cause of all those more concerning health issues. But to my surprise, it was also the cause of the attention and motivation issues that had plagued me for most of my life. After 3 or so days off of gluten, my mind suddenly felt so much more clear, and since then, I've been much more able to pursue my interests. I didn't get diagnosed, but the closest disorders I could find are gluten-induced brain fog (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7454984/) and the beginnings of gluten ataxia (https://jnnp.bmj.com/content/74/9/1221).

I'm not saying that you have the same thing, but it could definitely be a medical condition if you don't respond well to therapy or antidepressants. I wouldn't overlook the physical side of things.

I've tried the no gluten thing, and really felt no difference what so ever. I really had high hopes that was the issue since a lot of friends also reported feeling much more energy and motivation.

I did try going completely carb free for a week one time. I had no energy crashes which was great, but, I never really felt dramatically different mentally. While I wasn't crashing, I also wasn't suddenly feeling much more focus or "energy" (motivation, interest in work).

I was just kind of, stable low energy / motivation. Rather than, mostly low energy / motivation with some occasional really deep crashes caused by carb blasts.

Have you tried fasting? I have found it an effective antidepressant and stimulant. There are also some interesting health benefits (mostly to do with autophagy, cellular and subcellular cleanup mechanisms).

But yeah, I am also ill suited to modern life, and I'm working towards being able to spend as much time in the woods as I need.

I haven't actually tried fasting. The longest I've gone without eating is something like 20 hours.

I should give fasting a try though, I believe in the research. My hesitation has been that I am pretty low BMI. I seem to struggle to keep weight on even if I'm eating a normal amount.

I was in a similar state when I was about 33. Burnt myself out coding for startups and really got bored of programming. Found I was doing a whole lot of things I didn’t really enjoy and putting off dealing with some internal issues (for example, a childhood trauma from drowning and the fear of swimming that came from that).

Not that what works for me would work for you, but one day at about 33 I made a commitment to myself that I’d find a path through my body. Not sure why it was that, but it intuitively felt right. I had one ego melting psychedelic experience, started working with a swimming coach, dedicated myself to a yoga practice, got back to daily seated meditation, went to therapy, and journaled every day (did The Artist’s Way workbook to start that habit, which I have mixed feelings about but journaling is transformative).

It wasn’t all at once, it started gradually, but it started with a commitment that I’d find a way in through my body. Things aren’t all great all the time — sometimes I really dread getting to a yoga mat to practice, or wake up not wanting to sit for meditation. And I definitely have existential lows. I just am much better equipped to deal with things now.

Your physical practice might (likely) look totally different than mine, but I do think there is one that will bring joy and transformation for everyone. Maybe it’s martial arts, maybe it’s strength training, maybe it’s running, maybe it’s dancing, maybe it’s doing something like Wim Hof cold exposure training. Who knows, for me it was Yoga, but I’d really recommend everyone find that thing that gets them working through the layers of their body. Your 37 year old self will thank you.

I had to try three or four before one helped, so my advice is not to give up too soon. Welbutrin ended up being a solution for me.

It is very clearly depression.

I'm leery of the meds, however. They have a tendency to be highly addictive.

Also, the underlying cause might be something else; the depression might be a symptom instead of the root cause.

Chronic fatigue syndrome is a real thing. Inflammation, or perhaps aftereffects of some viral infection.

Or loneliness. We are social animals, the animal is supposed to be part of a group. Yet we've created this society which worships the idea of the individual.

Agree, but in my experience medicine simply kept me from going too low. Some kind of therapy may also be needed, and a focus / prioritization on things that make you happy.

There's still significant value in not going too low. I have a sense of existential dread that makes me forever unable to end my own life, but that doesn't mean I haven't thought of it. I've been at points where I definitely did not want to continue living the way I was, but I didn't want to die. For those who don't have that sense of existential dread keeping them on this planet, not going too low can literally be a lifesaver.

Yes, meds don't solve the underlying issue. There is no happy pill. They just give you the boost you need to fix your life. This is shown by studies that show depression comes back after discontinuing meds, but not after discontinuing therapy.

When my partner took anti depressants they increased the need to sleep.

Mirtazapine will do that to a bit of an extreme. Escitalopram didn't, at least for me, in some ways it made it slightly more difficult to sleep. This is in my body, so everyone's mileage may vary. I found the massive drowsiness of mirtazapine so difficult to deal with that I ended up preferring the frustrating sexual side-effects that escitalopram has (and found it more effective for my depression anyway).

Lately, the buprenorphine injection I get once a month is all the antidepressant I need. Still has side-effects, but these are ones I'm very used to at least.

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