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Comment by ljm | Hacker News Reader

This was one of the factors that made me think twice about going back on anti-depressants, until I made peace with the fact that my ability to orgasm wasn't going to pull me out of the hole I was in. It's a shitty choice but the desire to not be suicidal forces your hand.

It's literally like flipping a switch. One day, the plumbing works. The next day, it doesn't. Many times I'd just give up, out of boredom.

The side-effects are clearly stated but to use myself as an example, I vastly underestimated just how strong they would be.

That said, if you're dealing with the big black dog as it were, don't use it as a reason to avoid anti-depressants if you really need them. Keep your doctor up to date about the side-effects so they can adjust your prescription. And don't be shy just because you're talking about your private parts.

And make sure you have a therapist too.

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Have you considered augmenting with something like Wellbutrin? Some people find it helps with the side effects. I've tried it myself and while I found it was too anxiety-inducing (I felt too keyed up) there's truth to that at least.

No, not personally. I eventually was able to come off the medication. Took a couple of weeks to get back to some semblance of normal but I'm sure there's permanent damage still.

That said, it's not easy to walk away from suicidal depression (and attempts to commit suicide) without a decent helping of trauma, and potentially even PTSD. So, of course, there isn't really a 'normal' to go back to once you've got the awareness of that and how far down the rabbit hole you fell. Normal becomes something else.

Wellbutrin has no sexual side effects (the opposite, in fact) and is very effective for depression (but not anxiety). You might want to give it a try if you are still struggling. Of course, it comes with its own tapestry of possible issues.

Either way, hope you are doing OK/OK enough.

You ever look into ketamine for treating depression?

Self medicated this past weekend and had some major breakthroughs with my long time depression/suicidal intrusive thoughts. Nice thing is you don’t have to stay on it unlike other antidepressants—I would never do a medication that you have to constantly take.

Try 2F-DCK. Many benefits but no K-hole.

"I would never do a medication that you have to constantly take."

Tell that to your heart doctor when you're 70.

Probably will.

Ketamine can be pretty rough on the bladder and kidneys. Please read up on the risks. It is definitely dangerous to take recreational doses several times per week - it seems that low/moderate doses every week or two avoids most of the problems while still providing therapeutic effects, but definitely keep an eye on the health of those systems, ideally with letting your doctor know so they can help.

Many of users on /r/researchchemicals using either ket or novel analogs at recreational doses regularly for both fun and depression relief end up with bladder issues after over-consuming for a period - so while it's a promising depression treatment, I'd recommend caution around dosage and frequency and titrating to find your minimum effective dose.

Recreational doses are 10x-30x that of medical doses and those effects are quite a bit less at medical doses

https://astralcodexten.substack.com/p/drug-users-use-a-lot-o...

Of course, anything taken in excess has risks.

I just lost a friend to Ketamine, and there is another thread on the front page about someone famous who destroyed their life with it.

Ketamine seems like a miracle but a ton of people cant control their usage of it at all. Even if you think you know how addiction works, Ketamine sneaks up on you in a way cocaine, heroin, and oxytocin do not.

Please be careful.

Of course, I am very responsible with my illicit drug use. Probably did < 50mg across several night and am not planning on doing it again for 6+ months. Good advice though for everyone!

I appreciate the concern but, honestly, it's exhausting to keep fielding 'have you tried...', 'have you looked into...', 'have you explored...' questions.

I get that it comes from a good place, but I'm sharing my experience, not asking for advice.

The best help you and others can offer is to just listen, instead of offering another solution.

There are two replies to me in the 'have you tried' vein. I'm not aiming it at you specifically, just trying to stop a pattern.

I get what you’re saying. The only reason I suggested looking into it is because they are seeing hugely promising results (70%+ reported improving symptoms) but you only have to do a few sessions. It’s not another pill you have to take each morning.

For what it's worth, from at least one person's perspective it's exhausting to just read these replies, as if you or other OPs are eternally naive neophytes with no experience or understanding, or that providing a personal anecdote is automatically, implicitly, and irrevocably requesting advice. This tends to be the case with a lot of medical discussions online, but especially with mental health.

(It would be somewhat better if these questions were asking for advice themselves—"Have you tried $medication? It's been recommended to me and I'm interested in others' experiences"—but it's almost always "Surely you haven't tried ($medication || $lifestyle_change || $religion || just_grow_up()) because I have and it's a panacea.")

Thanks. I just want to share and be heard, and maybe someone can relate.

Good intentions all around, but people need to understand that you're not always someone to be helped or saved. It can feel quite disempowering at times.

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