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Comment by staticassertion | Hacker News Reader

> I know this road leads to SSRIs at the very least, so I always reply in the negative.

Seems odd. Your doctor can't force you to take anything. If they say "do you want to try X?" just say "No". Not giving your doctor full medical context seems like a mistake - for example, maybe depression would be indicative of another issue, or maybe people who are depressed really shouldn't take a specific medication.

To each their own, and perhaps you have other reasons, but this seems like a less than ideal solution to a very trivial problem if the goal is just to not take an SSRI.

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N=1, but last yearly physical my primary care doctor asked me if I ever had anxiety. I said yes, but that I wasn't really interested in treating it outside of lifestyle change. They asked if I wanted a prescription for prozac, without explaining anything about how to does it or titrate up or down or a time frame. I said I wasn't interested again, and that I particularly didn't want to take any medications that you can't just stop taking one day on a whim (a statement she didn't respond to).

She then proceeded to say "well I'll just write you the prescription anyway and you can do your research later and decide to fill it or not".

I was actually shocked by this interaction, and think about it often. She's a regular family doctor with the local hospital system, and this was just a regular checkup. I answered one question with a "yes, but it's manageable and I think I can handle it with lifestyle change" and then said no twice to medication and ended up with a prescription, which I ignored but don't appreciate having on my record, since it's a false indicator for future prescribing physicians.

Likely the office was getting a kickback from the supplier for writing that prescription. This is shockingly common in the US. A straight cash payment is prohibited, but it's easy to work around that legally and provide equipment or "compensate" some other expense.

Crazy. I hear such wild horror stories with doctors. I'd never return to a doctor like that, sorry you had that experience. Still, this feels like a case where the lesson is "get a new doctor" not "lie to one" but I understand that circumstances can make that a pain.

Agreed. A friend of mine is a primary care doctor, and it's remarkable how often people come in for depression and after examination and labs it turns out their depression is heavily influenced by other issues, especially low testosterone or hypothyroid. A lot more people have issues with these than most people realize. There have also been people he has seen who were reporting depression, often where nearly every anti-depressant had been tried, where getting treatment for ADHD massively improved their case and was life changing. As much as people like to hate on Adderall nowadays, for people with ADHD it is miraculous.

Getting treatment for "depression" doesn't always mean SSRIs etc. Sometimes it means treating the underlying condition(s) that are having downstream affects. I would suggest everyone gets their Testosterone levels checked among other common things.

I am in that case, low testosterone and hashimoto (hypothyroid), ADHD and big Scolioses. Last weeks I am dealing with insomnias, and had to take pills to sleep and it seems my parasympathic system is in alert mode for years, stress, divorce, ex-kid and older kid, etc.. I stopped SSRI after 21 years for 5 months and its probably causing my insomnias, the brain was not used for missing serotonine and brain don't stop thinking, loop, alert mode.

I am doing several blood analysis with a functional doctor and lyme may be around or was in the body, and so many other things. I was thinking I had lucky gut, but seems negative..

I did get my Vit D up to 65 and I seems to be issues with ADH hormone since kid and probably that makes dehydration. It's a fucking nightmare..

I may only see a testosterone replacement as a solution maybe..

>often where nearly every anti-depressant had been tried, where getting treatment for ADHD

This is actually a somewhat difficult diagnosis to make, especially when diagnosing adult ADHD without the user documenting and bringing in a well defined log of their behavior (and possibly another person to point out things they don't know about themselves).

>ADHD is a highly heterogeneous disorder with a significant comorbidity rate.

Is thing that you read about in literature around it. And even more common than that is the comorbidity of all the above symptoms, that is ADHD and depression + more in autism.

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