How can I learn to work without medication?

January 1, 2007 8:36 AM

How can I learn to work without medication?

The short story: I'm not able to get things done. It doesn't matter whether these things are hard or easy: I can spend an entire day trying to write a single short email or wash a fork and plate. Part of it is that I get distracted (on my way to wash the plate I'll start looking at a book) but part of it is that I can't seem to care enough anymore. I can be in a situation where things will be very bad if I can't get something done, and I'm aware of it, and I care about it in theory -- but it's not enough to make me able to even get started.

I've always been this way, but not to this extent. I used to be able to go into panic mode at some point and finish things, even if not very well, but these days I can sit in front of an unpacked suitcase and know that I have half an hour to get to an airport and still not be able to move.

Things like making lists have never helped: for one thing, sometimes I can't make myself make them; for another, I get hung up on making them and use that to put off doing anything else; for a third, once I make them I still can't make myself actually do any of the items on them. Breaking tasks up into small chunks is a good idea, but I get hung up on process (which parts depend on which others?) and usually get stuck at some point and can't make myself carry on with the rest.

There are obviously exceptions to this, and sometimes I can actually start things and sometimes even finish them, but most of the time it's too little and too late. I'm writing this post, but the process (signing up for an account! Posting!) has taken about a month. Work life is a problem, because I screw things up, and am aware of it, and can't stop myself; that also means I can't take on anything I really care about.

I'm really sick of this. I've always wanted to avoid taking drugs, for a bunch of reasons, one of which is that I don't want to be stuck taking them forever; if it were a matter of 'take these for a year, get your life back on track, and then carry on without them' I would feel better about it, but I'm worried about the likelihood of that. (Drugs are also a problem because you have to take them regularly, and that is hard. I can't even make myself go eat sometimes, even if I'm starving. It's really that bad.)

So this is a last attempt before medication. Have any of you ever been able to improve your concentration or self-discipline or ability to panic when necessary in non-medical ways? To clarify, I have read most of the information I could find about this, and I know most of the things that are supposed to help, but what I would really like is specific experiences with as much detail as you can give. For example, if meditation helped you, personally, how did you learn how to do it, did it take a long time until you were able to do it regularly, and how much of a difference has it actually made? What sort of things have helped you keep up good habits for more than a few days at a time?

For what it's worth, I don't drink coffee or soda (they make me feel sick), I eat decently healthy food, and while I don't do sports (I've tried, but I've never been able to keep things up for more than a few days) I do do things with low overhead, like taking very long walks pretty frequently. Sleep, which involves two processes (going to bed and getting out of it), is beyond fucked up.

Thanks for any and all help. And happy New Year :)

posted by anonymous to health (28 comments total)

You might try reading up on sensory integration. It can give you these symptoms, but responds well to sensory treatments. If it isn't your issue these treatments won't help, but it is one last thing to try prior to medication.
posted by caddis at 9:18 AM on January 1, 2007

Whoo. Dude, my problems are nowhere near as bad as yours and I finally broke down and medicated myself this year. It's improved my life (and my work life, and the amount of stress I carry, and my health since I'm no longer drinking 20 cokes a day, and my relationship with my girlfriend and relatives...) to no end. I should've done it years ago.

I did use the 3 main behavioural modifciations for 'getting things done' -- break tasks down into small components so that they aren't overwhelming, pick a place and get started so that I can get into hyperfocus, and use a timer that 'dings' every few minutes as a check to make sure I'm still doing what I'm supposed to be doing. Those worked to a limited extent before ... post-medication, all of them work and work well ... but I still do have to do them. I had those coping strategies in place before I medicated.

I'd reccomend getting with a good neuropsychologyst or psychiatrist before going on medication.
posted by SpecialK at 9:21 AM on January 1, 2007 [2 favorites]

I know your specific question is basically "What do I do to avoid medication?" So this may not be the exact answer you want, but it's all I can offer:

I was in a similar place, and consider myself very strong-willed when it comes to "forcing" myself to change. I am extrememly patient with other people, and in general am a person who doesn't let things bother me too much.

In my quest to avoid medication, I tried the following, with varying success:

-Relaxation techniques: closing my eyes, and focusing on each part of my body, and making myself relax. It's amazing how many muscles can be tensed without you even knowing.

-Prayer/meditation: I would pray and meditate, and read scripture, making myself focus on higher things, and get my mind off of myself.

-Exercise: Walking, bike-riding, tennis, golf. But it was difficult to get over the hump and even feel like doing these things, so I couldn't sustain any of these things on a regular basis.

I can tell you that in my case, none of these things was successful enough to help me in any long term way.

So, I'll tell you the part you may not want to hear.

Like you, I am by nature anti-medication. I would rather do anything else than be on any regular medication, especially for mental or emotional issues.

However, over the last few years, I was thrown into some very difficult and emotional life decisions.

I had much of the same symptoms as you: things I enjoyed "in theory" (photography, design, solializing, etc) became things I avoided or just didn't have enough focus to do. I was able to work ok, but anything extra was a huge effort. I would have ideas to take some photos, or even just frame some of my old photographs, but by the time I would get home, it was easier to do nothing but sit and vegitate to whatever was on television.

During this time, I saw a psychaitrist every month or two. She suggested anti-anxiety and anti-depressant medication, but I was entirely resistant. I told her I wanted to try others things first, like self-talk, and just trying to "pull myself up by my bootstraps" and getting on with things. But none of that worked. My symptoms got worse and worse.

I finally got to exactly the point you descibe:
I'm really sick of this. I've always wanted to avoid taking drugs, for a bunch of reasons, one of which is that I don't want to be stuck taking them forever; if it were a matter of 'take these for a year, get your life back on track, and then carry on without them' I would feel better about it, but I'm worried about the likelihood of that.

Even though my symptoms were not life-long, I had no idea whether I would have to take meds forever, or just for a while.

But I got to where I could not deal with my symptoms anymore. The lack of motivation wasn't the biggest issue, however. I was experiencing anxiety that caused literal pain in my feet and legs, causing lack of sleep and just a general "I want to scream" feeling. So I went back to the psychaitrist.

She told me: "If you had to dig post-holes to build a fence, you could do it with your bare hands. But wouldn't you rather use a shovel?" I agreed to start taking a daily medication (Lexapro).

After about 3 weeks, I can not describe the difference! I didn't feel "drugged up." I just felt much more normal, like "me." I put myself through a lot of unneccessary suffering, but I did have to get to the point where I knew I had to start the meds, and not be talked into it.

It still takes some effort to do the things I enjoy, but at least I can do them, and get pleasure from them. If I had it to do over, I would have started the meds sooner.

My psychaitrist says that after 6 months or a year of feeling "normal" I should be able to wean off of the meds. Again, my situation is different than yours, as it was brought on by specific circumstances. However, I am content that if I have to stay on the meds for a long time, or even the rest of my life, it's better than living in misery.

So, you might need to just give it a shot. And it may take a few tries to find the right thing for you. But speaking as one who has been in a similar place to you, I can say that it's definitely worth trying; don't let fear and "what-ifs" keep you from being your best self.

Since you want to avoid medication, I hope you can find a way to do that. Maybe someone else can leave advice in this thread that is exactly what you need. It is possible to avoid medication. Many people are able to do it.

In my case, I'm glad I finally listened to my doctor, or else I would probably still be stuck in the same place, and getting no joy out of my life.

Good luck to you!
posted by The Deej at 9:43 AM on January 1, 2007 [2 favorites]

Congratulations on taking the step to ask about this.

IANAshrink/therapist/doctor, but to a certain extent I have the same problem as you. Unfortunately, I have not been successfully diagnosed. When last I saw a psychiatrist (my health insurance ran out), he thought it might be some combination of anxiety and depression, or possibly bipolar-II (which is different from 'regular' bipolar). I have also tried Lexapro and Effexor to no effect, but what works for one person will not necessarily work for another, and vice-versa.

I have been told that it is quite possible to use medication to 'jump-start' your life and break the cycle of inertia, and then let therapy do the rest. This might be worth exploring for you.

With or without medication, you might be able to benefit from therapy. There are lots of threads in the archives here about finding a good therapist, and this search from craigslist seems very helpful (it lists whether fees are offered on a sliding scale, too, if money is a concern).

In the meantime, try to identify what's at the base of your problem: is it anxiety? Do obligations and chores fill you with a feeling of panic or dread? Do you feel like you just can't focus long enough to get things done? Does your thought process feel fractured? Do you simply feel numb and unable to move?

What makes you finally get things done? Do you just have 'good days' where it feels like the fog is lifted, or is it the last-minute push when you realize you can't put things off anymore? Are there any rewards you save for yourself (you mentioned reading and taking walks) or activities that serve as a mental refuge for you?

Those are just some things to think about to identify what you might want to discuss in therapy, and to help you help yourself in the meantime.

If you find yourself unable to find help on your own, consider enlisting the help of a friend or family member. Have them make an appointment for you if you need to, and remind you to go to the appointment. Some therapists offer e-therapy, and although I understand it's not a substitute for in-person therapy, it might be a good way to ease into the process (in other words, keeping an appointment with your computer is much easier than keeping an appointment for which you have to shower, pick out what to wear, get in the car, drive, talk to people, etc.).

I wish I could be more helpful, but I'll just end by reminding you that you that you are not alone, and that I wish you the very best of luck. If you feel like it, post a follow-up through jessamyn (or me, if you want: fuzzybroccoli at yah oo dot c om); I'd be interested to hear how you're doing.
posted by AV at 9:49 AM on January 1, 2007

This may sound odd but: why not read up on what the available meds can do for you? The idea here is that if you understand, on a neurological and biochemical level where this behavior comes from, you may be better able to deal with it without medication.

You can't manage a broken leg by gritting your teeth and "walking it off." Likewise, you can't expect to cope with a physiological problem through willpower alone. Understanding your condition may lead you to a more successful strategy.
posted by SPrintF at 10:05 AM on January 1, 2007

Wow, I was just struggling with my own motivation issues, making lists of what I really need to accomplish this year, kicking myself for the rut I find myself in, when I took a Mefi break and read about your troubles. Boy I loves the internets -- so easy to find someone whose troubles remind you of your own, but are so much, much worse. So thanks for that. Dude, take the drugs already! Consider it an experiment, and really, what do you have to lose? It's technology, a reboot for yer brain. Plus, I'm pretty sure you don't get any bonus points for the suffering....


"It's not your fault. No one asked you to suffer. That was your idea."
-from 'Bringing Out the Dead'


Good luck, and happy new year.
posted by Bron at 10:34 AM on January 1, 2007 [1 favorite]

I've been taking cold showers a couple of times a day for a few weeks and the results are much better than from anything else I've tried for my depression and concentration problems (including meds). The world just seems so much more interesting and colourful, and I have energy for doing creative things that I haven't had in years. Check out this page on cold shower cures for more people who have found similar benefits. I appreciate that this may sound like an insane suggestion given your particular issues but give it some thought - I didn't think I could do it either, but it feels so good afterwards that within a few days it's really not all that hard.

I'm not great at details, but I can tell you that my friends have noticed how much happier and more talkative I am. I've gone from being the guy who never says anything to the guy who cracks jokes all the time. If I need to do the dishes or go to the store and can't face it, I can jump in the shower for a few minutes and once I'm out I'll find that I feel good and have plenty of motivation. Because I feel good for at least part of the day every day I'm becoming more aware of the things that make me feel bad, (like fatty, salty meals) and getting better at avoiding them. Every sensory input feels like it has the volume turned up.

One way or another, I think you need a physical solution. Things like meditation are great but you need some basic concentration and awakeness to work with first. Whatever comes out of this thread I suggest that you set a date after which you'll look seriously into medication if you haven't found an alternative by then. When I tried drugs I was told that they were intended to be a relatively short term thing and not the life sentence you're worried about. But do try the showers. I did it the first time because I had had a particularly bad few weeks and was desperate to feel anything at all.
posted by teleskiving at 11:44 AM on January 1, 2007 [1 favorite]

I'm not on any medication now, but I have been on medication, and even the fact that I've been on it in the past is helpful to me now. Medication allowed me to have more "normal" thought processes. I obsessed less, I got more done, and I didn't go down the inner roads that lead to a viscious cycle of depression and self-destructive behavior. And now, I have the memory of being able to operate like that. Having that memory enables me to re-create similar thought patterns in the present. For example, I might start to get depressed over some bullshit, and suddenly I think "You know, if you were on prozac right now, this is exactly the sort of thing that you wouldn't think was worth worrying about." And then I can make a choice about my own attitude.

In short, the world of medication is complex and personal, and exploring it need not be a big sacrifice in terms of your long-term goals.
posted by bingo at 11:50 AM on January 1, 2007 [1 favorite]

bingo said exactly what I was going to say, only said it better. Temporary medication can give you insight into normal thought processes, and you can retain those memories, even after you've decided to stop using medication. For me, I did sort of the opposite, when I stopped taking recreational drugs: remembering the weird euphoria I'd have and how little things just no longer mattered, reminded me that the mattering may have been much more in my own head [and thus manageable by me] than a result of some out of my control circumstances.
posted by jessamyn at 11:57 AM on January 1, 2007 [1 favorite]

Anonymous, I have/had many of the same issues you're encountering for basically my entire adult life. In the past I've always been able to deal with it on my - either through exercise or life style changes or whatever, but I've never been able to consistently maintain my ability to do quality work or stick with school.

This past fall I reached sort of a breaking point where I messed up pretty severely with my school. I basically shut down for about three weeks. Surprise, surprise - this "depressive event" coincided with getting out of a long term relationship and moving into a new place out of necessity rather than choice.

As I said, in the past I've always been able to deal with these sorts of stresses on my own... but this time it was really bad. So for the first time ever I sought professional help. Through my school I found a counseling center and went in for several interviews before I was finally set up with a weekly counselor. In addition I started taking Wellbutrin to help with my background depression and motivational / concentration / attention issues.

I like you never ever wanted to take medication. I've seen too many people become tweaked out on various drugs. I've known several who took a cocktail of prescription drugs throughout the day... I was scared to death of becoming dependent... but mostly I was just scared to admit I had a real problem.

I thought as long I could "take care of it myself" that there wasn't anything really wrong with me that discipline, diet, exercise, and self improvement couldn't take care of.

But recently I've realized that all those times in the past that I thought I was "taking care of it myself" I was really screwing up. My issues (which almost exactly mirror yours) have cost me relationships, jobs, and have ultimately set me back years in finishing my education and beginning a successful career.

I was incredibly resistant to starting medication. I augured with my shrink about it but finally came around to a simple understanding: it's brain chemistry. And while there is a lot you can do on your own, sometimes what you're missing is something that no amount of sun light or exercise or self help books will replace.

I'm going down a road I've never been on and I don't know what the future is going to be like, but I do know that three months into the medication I am incredibly better off than I was before. It hasn't been a dramatic change, but I notice a dozen little things every day that I'm doing now that before I would never be able to follow through on. Getting up on time, washing dishes, checking my schedule (my god, I'm keeping a schedule now!), planing for the spring semester, and a million other little daily life-tasks are coming more and more naturally to me than before... and for the first time in a long time I'm not sitting around staring at the floor or the ceiling for hours on end or making endless lists which I never start, let alone finish.

Anonymous, I don't know how old you are or how long this has been going on in your life - but don't do what I did and waste years of your life fighting a battle you probably can't win on your own. Get help. Medication may not be the answer (I hope it's not!) but until you consult with professionals - people who are trained to help people like us - you won't know.

Please take care and I wish you the most sincere and best of luck!
posted by wfrgms at 4:59 PM on January 1, 2007

On preview exactly what The Deej said.
posted by wfrgms at 5:10 PM on January 1, 2007

I'll be the dissenting voice here and say hold off on the medication while you consider other options. I was on medication for two years for anxiety and depression (Xanax and Aurorix, the Aurorix was later replaced with Serazone) and I felt drugged. Yeah, sure I wasn't quite as panicky, but they turned me into an unfeeling zombie. I couldn't even react to things properly; I was always in a state of "meh". After a while even the lowest dose of Xanax made me feel overdosed, so I stopped and haven't gone back since (and it's been 3 years).

I do occasionally get panic attacks or depressive moments, and like you I'm a major procrastinator. I've noticed certain "triggers" - hunger, stress, being gassy, tiredness. If I can get one or two of those factors sorted I'm better. I also have a herbal spray (St Johns Wort+chamomile+something else) that I take when I'm really anxious; works like a charm. As for the procrastination - well, I'm still sorting that out, but I get things done on deadline, and they turn out well. So perhaps it's a different work style?

People have been my best cure. Is there someone in your life whom you can count on for support, maybe even a hug or two? Physical touch, in particular, has helped me; my boyfriend is incredibly relaxing (and all he has to do is cuddle!), and some contact with friends also helps the mood.

Good luck!
posted by divabat at 5:22 PM on January 1, 2007

1 Wellbutrin a day, I take it with my coffee every morning. The prescription is mailed to my house, my doctor and I have a standing arrangement to refill it. It's as automatic as I can make it. And its the only way I've found to keep myself moving forward. But its only one pill a day, every morning. It's not mood-altering, it's got very light side effects (I don't even know what they are anymore) and I recommend at least trying it out to see if it helps.
posted by disclaimer at 6:03 PM on January 1, 2007

Having a friends and family roster that looks like a final exam for a psychiatry program, I cannot understand why people are so averse to taking medicine when it can MAKE YOU BETTER.

Look at your symptoms. You can't wash a dish? Can't pack a bag? And people are recommending cold showers and St. John's Wort? (I'm not knocking what works for you, but this seems out of place for what the poster is describing.)

You are sick, and you need help. But let me say as loudly and boldly as I can THERE IS NO SHAME IN THAT! Would you be ashamed if you had a broken arm that needed a cast? Would you be ashamed if you had an infection that required antibiotics?

Please, please, I am begging you, muster every ounce of motivation you can, and get help TOMORROW. You can be feeling better THIS WEEK. If you can't find the motivation to do it, then ask a family member or friend to help.

And please erase from your mind this nonsense of not wanting to be "medicated". We live in an era of, quite simply, miracle drugs. Drugs that 50-100 years ago would have closed most of the asylums in this country. It would be like saying you don't want to go to the eye doctor to get your vision improved because you don't want to be "one of those people" who has to wear glasses/contacts all the time. Surely you see the absurdity in that.

You somehow made this post. For that I am thankful. That shows, and should prove to you, you are not hopeless. You are slightly off track, that's all. And you can get back on again.

I love the analogy above by the counselor. You can dig a bunch of post holes by hand, or you could use a tool specifically designed for the job to make it much easier.

Get yourself to a doctor tomorrow. Let me say it again, you could be feeling better THIS WEEK.

Go. Shoo. Shush! Just go!
posted by Ynoxas at 9:07 PM on January 1, 2007

And please erase from your mind this nonsense of not wanting to be "medicated". We live in an era of, quite simply, miracle drugs. Drugs that 50-100 years ago would have closed most of the asylums in this country. It would be like saying you don't want to go to the eye doctor to get your vision improved because you don't want to be "one of those people" who has to wear glasses/contacts all the time. Surely you see the absurdity in that.

Let's not argue. The antidrug point of view is valid, because these drugs are not well understood and they affect your BRAIN. There are horrible side effects for many people. Let's not argue. Both sides should be CAREFULLY CONSIDERED, not poo-pooed.
posted by Listener at 9:20 PM on January 1, 2007

Listener: I'm not saying it to argue, I'm saying that for someone who cannot pack a suitcase before a plane is about to leave, there is something else going on besides needing just the right pocket-organizer method or the right positive attitude.

Someone else can be the proponent for the anti-drug coalition. I will be the proponent for modern medicine and pharmaceutical technology.

Of course there are side effects for some people. Peanuts can be fatal to certain people.

But all I can do is assure you I have the poster's best interest in mind, and I am making a good-faith suggestion, a plea actually, to seek professional help immediately.
posted by Ynoxas at 9:55 PM on January 1, 2007

Ynoxas, you said you cannot understand why people are averse. I just explained exactly why.

Anonymous, you need to get out of your rut and find something you care about. My cure-all question for emotional type problems is get what you need. We need stuff. Apathy means you are not getting what you need. You don't even know what you need. Just thinking about that a bit and posting several notes for yourself should start to get it under your skin so you start to care. Motivation. Action. Results. But first you have to feel something. I've totally been there. And there are better ways to heal than trusting your mechanic (pdoc/therapist), even though they sometimes make good assistants. Trust your gut. Maybe you don't wanna pack because you shouldn't be going on the trip. You need to understand what you're feeling. Zen may be telling you the little you doesn't matter, but on some level, your little bit of self does matter. You seem emotionally frozen up.

I am sure as hell not a mental health professional of any kind, though.
posted by Listener at 10:04 PM on January 1, 2007

I will agree with Ynoxas that professional help is needed. My psychaitrist did not try to force me to take meds. She respected my wish to NOT take them, and worked with me in that. When I had exhausted all other methods, she was ready with an Rx. Never an "I told you so."

If you are averse to meds, still go to a pro, and just let them know your stance. A good professional will respect you, even if they don't agree. And they will try to work within your convictions.
posted by The Deej at 10:13 PM on January 1, 2007

[please take further pro/anti meds discussion to email or metatalk]
posted by jessamyn at 10:13 PM on January 1, 2007

Sorry, I got your long post mixed up with another one. Nix the zen comment. Meditation does help. Try sitting and doing nothing. You may get irritated --> motivated.
posted by Listener at 11:12 PM on January 1, 2007

Well I'll go ahead and say I don't think you're sick and, as you're not sick, you don't need medication. It seems you're depressed, severely bored, and generally anxious but you're not sick. In fact such feelings may be the appropriate, healthy response to particularly toxic environments. Traditionally, before the age of Prozac and "talking cures," people dealt with such feelings by initiating drastic changes in their lives. You say you've tried "everything" but it seems you've done nothing more than a few, minor lifestyle "hacks." It's stupid to think such tactical measures are going to have real strategic benefits. This is just more lazy, quick fix, "lose 20lbs in a week" thinking. I doubt meditation or volunteering or any such procedural solution is going to solve what is really a deeply structural problem. The problem here is you. It's unlikely that somebody as sheltered and pampered as you appear to be has any real challenges to overcome so, really, you are The Enemy. Getting out of a rut that you're stuck in and truly growing as an individual will require big, painful, unpredictable, messy, undeniable change in yourself. And since you, yourself, are not responsible and cannot be trusted to follow through on any given procedural solution and even the threat your own personal failure isn't enough to motivate you, your only hope is to put yourself in a position such that your individual growth doesn't require conscious effort and energy on your part. You can do this by taking medication, finding Jesus, or making drastic changes to your environment.

I'd suggest #3. My concrete advice would be to literally change your life and your self as much as you can. Dump your job. Throw/give away everything you own. Yes, including the stuff you think you need and supposedly couldn't live without. Humanity got along just fine before television, automobiles, video games, celluar phones, and wifi -- you can too. Dump your friends. They're obviously not very good friends if they've let you fall into such a sorry state of apathy. Find new friends. Similarly, if you have an SO then dump him or her too. Maybe take this opportunity to experiment. Move as far away from your current location as possible. Move to Australia, or move across the country, or move across the street. Move in with your parents. It doesn't matter where, but move. Change your appearance. Cut off all your hair and wear glasses and try a wardrobe that doesn't include t-shirts and jeans. If you can afford it, have some cosmetic work done. Heck, get a nose job. They're practically giving them away these days. Get a tattoo. They're lame and not very classy but so is California. And not a small, dinky tat that nobody will ever see. Get something big and tacky that you'll dearly regret in a year. Change your speech patterns and your writing style. Use big, fancy words and stop using 'I' so damn much. Change your diet. Whatever the "healthy food" you eat now -- just stop. You likely eat the same boring crap as most people (which would also explain your attitude towards food) so there's no great loss here. If you want a real motivation to exercise then try living at the top of a hill or geting rid of your car or building a house. Change your culture. Whatever your current tastes -- movies, music, art, literature -- it's obviously not very good or interesting so change that too. Throw out all the crappy media you've likely amassed and look for new stuff. I could go on and on but hopefully you get the point. Don't "try new things" or "challenge yourself" or adopt new routines -- make real, structural changes to yourself and your environment. You may worry that such enormous changes will hurt. They will. That's the point. If you're really at your wits end and you don't want to resort to medication then you've got nothing to lose which, you'll come to see, is a blessing.
posted by nixerman at 12:19 AM on January 2, 2007 [2 favorites]

Just a few follow ups:

Ynoxas, for a lot of people there is a feeling of shame in admitting you have something WRONG WITH YOUR BRAIN. Admitting you have depression or ADD or some combination of both is troubling for most people. For one there isn't a lot of sympathy from the general public. When I explained to one of my oldest friends what I was going through his response was, "Don't you think you're just being lazy?"

Personally I was in denial about my own illness. When I went in for my initial interviews with the shrinks I really expected them to look at me and say, "There is nothing wrong with you - drink less beer, eat more veggies, and get more exercise." But both of them said, "It seems like this is something you've been dealing with for years, you're illness is real, and here are your options..."

It was only after I accepted the reality of my problem that I came around to the idea of taking meds - before that they (the meds) were NEVER an option.

Sadly, I've seen friends go down that ritalin, or drug-x road and become either zombies or complete wired weirdos. I've seen people bounce from one drug to another with bad effects and I've known several who mixed and matched pills throughout their day. I really didn't want to wind up like that.

I wish that I had not spent years in shooting myself repeatedly in the foot over all this. I wish I had gone to a shrink six years ago. But I was afraid and in denial and basically I was exactly in the same place that anonymous is now.

I'm not saying that meds are the solution for anonymous - but he won't know until he goes in for a tune-up.

One other thing:

Nixerman's advice is ludicrous and borderline insulting to the poster. I'm surprised he didn't advise anonymous to "kill his television." I mean sure, we can burn all of our belongs and go live naked in the woods, and yeah, maybe we'll spend so much time shivering from the cold and running from bears that we'll forget about our career oriented lives and all the depression and anxiety of modern society... but who in their right mind wants to live naked in the woods, constantly chased by bears? Maybe nixerman is the one who needs counseling? Or maybe his post is some half-wit endorsement of meds? I can't tell. and I don't care enough to decipher his long winded, spastic, and insulting comment.
posted by wfrgms at 2:38 AM on January 2, 2007 [1 favorite]

Anonymous, at various points during my (admittedly short, only around 20 years) life I could have written this. I'm still struggling with it. I've been on and off meds.

Off meds, the best thing that's helped me is to keep a schedule. From you post I feel like I know exactly what you're going through. There are all these things in life that you should care about but don't. And when you don't you think something wrong with you, and you don't get them done so you feel like a useless waste, which makes you even more apathetic and suddenly you're in a vicious cycle that turns you into a blob on the couch staring into space or at the TV (or on the computer).

Part of my problem is there are a billion things I'm theoretically interested in and want to do, but they can overwhelm me and if I try to do them and don't, it's back to feeling like a useless waste and apathy and not doing anything.

So, to function, you first have to forget about doing any of those things. At all. They don't matter now, you need baby steps to put your life back on track. Make one goal to do one thing at a certain time each day, and do it. Don't make the goal to do it by that time, schedule it at that time. Personally, if I were you I would make it adhering to a sleep schedule. Nothing fucks me up like a bad sleep schedule. But don't schedule a time you have to get up and go to bed--baby steps, man! Schedule a bedtime or a waking time. If you can keep doing it then schedule the other time. And after that, you can set other goals. Maybe it is washing that fork and plate, maybe it is doing all the dishes, maybe it is making yourself breakfast or packing a sandwich for lunch. When you can do this you can add other goals, until maybe you're going for a run or practicing knitting or what-have-you.

I don't know, once I was able to prove to myself I could do things, it was a lot easier to do more things. And this makes me feel an awful lot better about life in general.
posted by schroedinger at 6:44 AM on January 2, 2007

wfrgms: Doing my best to respect jessamyn's instructions, all I will say is that I completely understand the stigma about taking psych-oriented meds, and that is why I try to tear down that stigma anytime this subject comes up. Noone stigmatizes a diabetic for taking insulin. That's all I'm trying to say.

Maybe I was too specific about the drug thing, because that, despite appearances, wasn't my thrust.

Let me re-frame by saying I legitimately believe it is in the best interest of the poster to seek professional help. That professional may or may not recommend medication, but that's not the important part.

I again make my entreaty to the poster to seek help today. TODAY. If you need assistance, ask a friend or a family member, or even an online friend to help make the appointment, etc.

You can be well again. It won't always be like this. Don't give up hope.

Despite differences of opinion in this thread, we're all rooting for you!
posted by Ynoxas at 7:17 AM on January 2, 2007

I've always wanted to avoid taking drugs, for a bunch of reasons, one of which is that I don't want to be stuck taking them forever;

This was my exact philosophy for a long time, when I self-medicated with caffeine, alcohol and whatever else. At a fairly low point, when getting some dispensation from a professor, the subject came up. She said "If you were a diabetic, would you refuse your insulin because you had to take it forever?"

I said no.

She said, "So take the damned pills." So I did, and the difference in my quality of life is almost night and day.

There's plenty of reasons to avoid medication, or specific ones, but just because you'll have to keep taking them shouldn't be one of them.
posted by phearlez at 7:25 AM on January 2, 2007

This is just going to echo what a lot of others have already said, but being on the 'been there, let me empathize' side, here's my take:

I tried for a number of years to go without the medication, with varying success. Sometimes, I could last for months, functioning well enough that I still had a job, my family wasn't completely exasperated with me, and I could wake up every morning not hating my life, and not fearing that another panic attack was on the horizon.

Knowing myself though, knowing what to watch out for, this summer I started seeing myself slip backwards, again. I had tried everything I knew, and made some progress.. but it wasn't enough. That's when I went to see the doctor - first, my primary, then the psychiatrist on the PCP's recommendation.

Talk to your regular doctor first. Talk about non-pharmaceutical options.. but please, please don't close your mind to the drugs completely. My psychiatrist put me on Effexor, and after titrating up to my maintenance dosage, the world is a completely different place for me. YMMV, of course, but the others are right:

Depression, anxiety, and lack of focus aren't always character flaws - they very well can be biological issues, medical problems as real and as problematic as asthma or diabetes or high blood pressure -- all of which can be maintenanced by a combination of medicines AND personal management techniques like diet, exercise, meditation, etc.
posted by Adelwolf at 8:10 AM on January 2, 2007 [1 favorite]

Depression, anxiety, and lack of focus aren't always character flaws - they very well can be biological issues, medical problems

I wish there was some way I could make every person in America read that sentence. Very well said.
posted by Ynoxas at 9:08 AM on January 2, 2007

I applaud you for seeking change without pharmacopia. I have a close relative who might be your genetic twin and I have seen his struggles. He has instituted a regimen of good nutrition, exercise, and meds, as well as seeing a therapist weekly. It has not done much to relieve his anxiety from what I can tell, but HE BELIEVES that he is doing better. I think the meds are the disruptive element. He is edgy, moody, has chemical high and lows that were not present pre- meds. I think that the meds are giving him a false sense of normalcy. Of course everyone is different.

Accept that there are things that you have trouble doing and try to define them. Think of them as an allergy and try to remove as many difficult things from your life as possible. The things that you cannot remove should be dealt with in the simplest manner to achieve the desired results. Simplify everything. Ask for the input of someone you trust to help get past the paralysis of planning, and to make sure you are truly simplifying things, and not making them impossibly worse. Keep a small kitchen timer with you to help snap yourself out of distractions. Pinch yourself to signify it is time to begin doing a necessary activity. Wear a watch. Do not over commit yourself. A simpler life can be gratifying, especially if you can relieve yourself of the sources of your anxiety.

If you eventually decide to take meds find 2-3 trusted friends or family members that you have regular contact with and have them give you an outsider's view of how the meds are working. The wrong meds are definitely worse than no meds at all.
posted by SMELLSLIKEFUN at 10:34 AM on January 2, 2007