Nick,

Fantastic piece. This connected with me on many levels. From start through to bottom - which is why I added a liberal sprinkling of highlights.

But perhaps most of all, the idea that admitting we have depression can be so hard.

When I first saw a psychiatrist, last summer, he floated the idea that my issues with energy and concentration may be ADHD or may be depression.

I was offered an SSRI or Ritalin. Blue pill or red pill. It felt oddly like The Matrix.

It's tempting to dismiss this as quack medicine. But apparently picking these two conditions apart can be challenging, even for expert diagnosticians, and sometimes trialing medications is just an easier way of getting to an answer. This is, incidentally, why seeing a medical professional makes so much sense and trying to figure these things out yourself, or via Google, is a failing gambit.

But coming back to the trial, here’s the thing (that connects with what you wrote).

I took Ritalin. Not because (deep down) I felt strongly that ADHD was likely the cause of these issues. But rather, at least in part, because it was an easier diagnosis to stomach. Being depressed is ... dark. Don't depressives have suicidal ideation? Who'd want to admit to something as menacing and bleak as that? Psychostimulants sounded like less scary drugs also. I think a large part of this was due to stigma. I’d never met anybody who had been open about taking an SSRI so I thought I was joining some kind of dark underworld. That’s why I’ve become a big believer in the power of sharing. If it helps one person to feel less alone and scared … it was worth it.

Anyway, after a year spent feeling progressively more productive but less happy taking stimulants - a strange feeling! - I realized that what I was describing as low "concentration" was actually better termed poor "motivation." I’m a writer. Who screwed up my own diagnostic process by choosing the wrong words.

I have the same self-esteem thing you mention. Things are getting better now, thankfully, but it's plagued me my whole life. When I'm stuck getting going on work for a client, it's less likely to be because I lack the mental capacity, and more likely to be because I'm fighting thoughts that say "don't bother, it's too hard. This [your career] is all a waste of time, actually." Without wishing to cause offence to schizophrenics who hear these voices, for real, I feel like there's a similarity there, even if the voices we hear only express themselves cognitively.

Also - and I really want to write about this - I felt as compelled you to share my story. I've found writing enormously therapeutic over the years and it's probably my favorite hobby. It felt odd to share so much of my life but keep these few pages stashed for myself. And as above, if it could help others, why not share?

I did, however, worry greatly about the potential professional repercussions (some people I know are enormously opposed to the idea of sharing). But I pushed on anyway after a short mental tug-o-way with myself. Every other person who chooses to share - and continues on with a career- gives me strength to know that it wasn't a bad choice. I looked up your profile briefly and thought “oh cool, seems like a smart guy.” I would never have guessed. As much as I’d love for you not to be depressed, all this encourages me.

By the way, the depression aspect of my diagnosis was dysthymia — or persistent depressive disorder (PDD) as it’s commonly called (or “low flame” depression or any other of a few other monikers.

Sounds like yours might have been too. I can never recall feeling unable to get out of bed. But I've been plagued by the kind of feelings you describe for as long as I can remember.

Sadly, I haven’t gotten as far as sharing this with friends yet. Just the world and Medium! I think I’ve pushed some people away by avoiding social events. That’s another horrible aspect of that. People imagine we’re snubbing them when really we just can’t muster the self-esteem to put on a brave face.

Took sertraline for a while, by the way. It's a great med although I’m now trying Wellbutrin. If the first one doesn’t work, I encourage you to try a second and a third and keep going back to your doctor. I really hope that your bravery in sharing your story pays dividends.

Thank you, again, for sharing it. I enjoyed the read. And you've empowered somebody else in the process!

- Daniel