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Comment by keiran_cull | Hacker News Reader

Regrettably, it's a cocktail of highly interrelated psychiatric issues:

1. cPTSD 2. ADHD 3. Depression 4. (Relatively mild / high-functioning) autism spectrum disorder

Likely combined with aftereffects from mild traumatic brain injury (i.e. a high number of concussions), but this part is largely speculative.

Would not recommend attempting to research your way into a solution without the help of a trained practitioner.

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I've been diagnosed with cPTSD, GAD, Depression, and ADHD. Ketamine therapy has helped to grow awareness & understanding but little in the way of behavioral change. I've avoided stimulants thus far as I don't want to resort to that path just yet.

What helped you? Traditional psychotropics? Psychedelics?

In terms of medication, my own personal experience has been:

* Ketamine was life changing (for depression symptoms)

* Stimulants help me a lot. The first time I took adderall, I cried, because I had never experienced such a relaxed state of calm or peace. I haven't been able to get any due to the longstanding shortage, and my quality of life has suffered as a result. Other drugs help me to control my focus, but they don't tend to help my memory or emotional regulation much.

* I also take antidepressants that are slightly helpful.

* Diet, exercise, and sunlight make a huge difference.

Adderall was great at first but literally a week of daily use and I felt like all it was back to normal.

Felt like Im just damaging my physical health for no good reason

How much content do you consume?

I’d say start your day off with absolutely nothing. Just go outside and go for a walk with no phone. No music. No technology. From the moment you wake up, try a one hour walk like this (map out a route that takes about an hour so you don’t need a clock with you). Let your mind fly, then after the hour is up, write down some notes about your thoughts. Try this for a week.

I consume a lot of content as a coping mechanism for what feels like an insurmountable stack of issues with no clear path to addressing them.

Then I think you already know the solution to getting unstuck.

> I've avoided stimulants thus far as I don't want to resort to that path just yet.

I'm interested in knowing why you're reluctant to try stimulants. what you describe in your OP sounds a lot like the symptoms of ADHD and stimulant medication helps many people with the exact symptoms you list with little to no side effects. why leave that on the table?

Mainly cardiac concerns. I tried stimulants for a short stint and my baseline heart rate was noticeably elevated.

Isn't that somewhat of a survivor bias? People with ADHD on stimulants would typically have little to no side-effects because if they had moderate to severe side-effects, then I doubt a medical professional would keep them on stimulants.

I treat my ADHD with stimulants, and I would say there are definitely side-effects, but the side-effects are mostly manageable.

While I do benefit from stimulants, I personally believe the benefits are exaggerated, and apparently the Cochrane Library does not disagree with me:

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

For ADHD, stimulants like Ritalin have the opposite effect. Your brain goes... quiet. In a really good way. You can focus on what you want to, with ease. If you have a diagnosis don't be afraid of exploring medical treatment. Just be aware that while it does solve the problem of being able to stay focused and on task, it does not solve the problem of figuring out what to focus on. Also some people react differently to different medications. If Ritalin doesn't work, Elvanse or one of the others might work better. It can take some trial and error to figure out.

I want to add, try starting with lowest dose! For me 3.1mg Adzenys or 10mg Vyvanse (both lowest dose possible) have a clearly noticeable and beneficial effect without overriding my core personality and preferred mental tendencies (though this along with a low/moderate dose of NDRI and SSRI)

Do you do caffeine?

There are some nonstimulant medications available, generally less effective. There's a good overview from a medical article published in a seemingly legit journal by seemingly legit authors: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000197/.

If you don't mind me asking, what was the source of the concussions?

I have a similar profile, along with seizures in childhood that led to repeated head injuries. Cause and effect was always an open question for me.

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