Comment by jmcgough | Hacker News Reader

Comment by jmcgough | Hacker News Reader

Therapy and a good psychiatrist is a great first step. When you have work issues, anxiety, and other things going on it can really be hard to tease out what's the cause and what's the effect.

A good therapist can help you figure this out, and give you better coping strategies.

It took me years to figure it out but I struggled to be consistently productive because of a mix of untreated insomnia, adhd and bipolar 2. What made the difference for me was really analyzing my symptoms, seeking out goal/skills-oriented therapist (a PsyD not a MFT), and not giving up after the first psych med or two didn't work.

I've seen people who really lack the awareness to know that they're underperforming, or the willpower to try to fix it and get help. Thankfully you don't seem to be one of those people.

Also, I'm going to echo everyone and say that you should probably get screened for ADHD. With ADHD it's very common for an inability to focus -> frustration that you can't get things done as fast as you should be -> depression/anxiety.

> There are phases where I work with high motivation but it fades easily. I have found I work on my side things with interest but I am not a completer. I complete around 80% of things and then leave them.

Probably describes most of HN so don't feel too bad about that haha.

I'm concerned about becoming dependent on medications I don't need.

I'm worried that if I go to any sort of medical professional they will succumb to "if the only tool you have is a hammer, to treat everything as if it were a nail" and I will end up on some sort of meds that I don't need.

I just have this impression that 80% of people could walk into any psychiatrist's office, describe their experiences, and walk out with a prescription or three.

I'd like it if someone could convince me that these are not legitimate concerns.

I'd actually agree with you there. If you walk into a psychiatrist's office and tell them you're having depression/anxiety, you'll leave with a script for an SSRI. They exist to write prescriptions and don't have the time to get a holistic view of you as a person, to figure out what's causing your symptoms.

If you're worried about unnecessary medications (the majority of which won't make you dependent or have long-term side effects), you can always start with a good therapist (I recommended a PhD or PsyD). But for some people, they're struggling enough and miserable enough that it makes sense to try psych meds early and see what helps.

> I'd like it if someone could convince me that these are not legitimate concerns.

Remember that you always have the option to not follow a treatment plan if you don’t feel like it’s the right thing for you. A recommendation from a physician isn’t an order from a judge that you must follow.

If the doctor you visit is good at their job, it should feel like a conversation about solving a problem. They should be able to offer a clear explanation on why they think their recommendation is the way to go and involve you in the decision-making process. Many people are reluctant to be medicated, so you probably won’t be the first patient they’ve seen just that day with that issue, and they’ll have some options for you in that regard too.

I used to have a concern about drug dependency so I feel like I might understand why you feel that way, but consider this: If you take a medication and it doesn’t improve anything, you’re not really dependent on it. If you take a medication and it makes things better, then things are better, which was the whole point of taking it in the first place!

Would it be better for your body to function well by itself? Of course. Would it feel better if we had a clearer understanding of psychiatric disorders and how to solve them precisely? Definitely, but medical science just isn’t there today, and at least there are some options that work for some people, even if we don’t understand why.

These are legitimate concerns. They may not end up being accurate, but they are legitimate.

There are a huge range of services available within the "theory" umbrella, some of which have 0% chance of involving medication. This may not be what you need, but it's a safe baseline. As another commentator stated ... don't think about theory, start doing it! In particular, talk therapy is a safe, often very effective, way of getting started.

Personally, it was instrumental to me to make some serious shifts in how I related to people and it took ~4 solid years of weekly sessions. A major component of this was having the space to take fears and anxiety seriously with the support of someone who didn't have (or really try to give) the answers, but was sufficiently anchored in life to provide a trusted second perspective.

Over time this let me identify some fears as wildly misplaced, some as valid but no longer applicable, and others as important enough to get a fire lit underneath me and do something about them. The resulting emotional freedom was life changing. Definitely I'm still a bit neurotic, but vastly more able to negotiate relationships, kindle curiosity into new hobbies (gardening and singing in particular, which I mostly never saw coming), and stay stable enough to grow in my career path.

Best of luck, friend!

"I'd like it if someone could convince me that these are not legitimate concerns."

They are legitimate concerns. Just don't use them as an excuse to not get started. You don't need to hit it out of the park with the first therapist. Hell you may go through a dozen before you connect with one that is more helpful than not.

The key is to get started, and then do something else if the path you started isn't leading anywhere. Iterate.

You can't iterate if you never start ;)

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