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I cannot stress this enough: I live for the day these cruel bastards get gulaged. This shit is why I'm a leftist.
this post was submitted on 18 Jun 2026
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CWs: Ableism, sui, drugs
Well, what is that source? The source of my ADHD is that something about my dopaminergic neurochemistry is totally fucked. What prevents that at the source is administering amphetamines. Behavorial measures are a massive help, and i employ a ton of these, i know how to organize tasks in a way that saves my limited ressources, i know how to stim to deal with inner unrest, i know how to talk to my inner child to calm me down when i am emotionally dysregulating, i have a robust support network of neurodivergent friends that get me and have similar needs and that i can hang out with if i need to socialize without masking. In short, i am fairly close to the optimum of behavorial and environmental means of coping with ADHD. And i should be, givent that i've had psychotherapy and ergotherapy and have read up on the stuff and whatnot.
But i am still not capable to live an independent life without strong psychostimulants. I am organically not able to be a functioning adult that routinely gets done more on a given day than take the trash out and go grocery shopping, and even that takes effort. Which is fine ig, there's pills against that and they work. Oh, they are also gatekpet af because people are scared of overprescribing psych meds.
Anyways, why i am hitting you over the head with a diatribe about ADHD, in a thread about SSRI's, is the simple fact that depression is very similar in many ways, just with a different neurochemistry behind it and different meds that can treat that. Yes, there are depressive symptoms that have exogenic causes, but actual depression is an organic issue and needs pharmacological treatment, to say otherwise is ableist "just do more sports and clean your room" crap that is actively harming people every day. I have friends that may not be with me anymore if they would not have been put on SSRIs in time. I know people who've lost loved ones because these loved ones decided, without telling anybody, that it was time to get off their meds and then the rebound hit them so hard they killed themselves. Antidepressants save lifes. Even when brain chemistry is not the root cause, they can be an indispensable temporary help that puts people in a position to got for the actual cause. Yes, there are people that would benefit more from talking cures and other stuff that's psychotherapeutic instead of psychiatric. But the solution for that is to make psychotherapy widely avaible for free, not to take away medication that can have drastic effects when it is discontinued too quickly.
really enjoying your posts as usual. i was wondering, is biology as the root cause the current consensus in depression research? (if that is what you mean, i may be misunderstanding you. i suppose "organic issue" doesn't necessarily discount depression being downstream of material factors) absolutely not trying to dispute the claim at all, i just haven't done the investigation myself and i suppose my vague impression was that there isn't exactly a great consensus on root causes in depression research. it was my strong impression especially that the jury is very much out on "chemical imbalance theory". i just want to know if i am way off base with this.
i know you did state that biology is not always the root cause. i have treatment resistant chronic depression myself and i struggle a lot internally wondering whether i would be a radically happier person in a better world or whether this is just something i would always have to struggle against to some degree. i have had great results from DBT around my other emotional problems but a lot of the time it does feel like my depression arises from my material conditions moreso. the way i generally lean is that my condition is more like "shit life syndrome" than something genetic or biologically rooted. just something I've been vaguely meaning to do more investigation on and wondering if you have any good places to look. i know this thread has turned a bit sour so sorry if i am adding to any stress by replying. sorry it's a jumbled string of thoughts also i am on the bus
My point was mostly that sometimes, it makes sense to treat the human mind as a blackbox. Our approach to psychiatric medication is frankly built around "let's try stuff that has a track history of working", and many behavorial forms of psychotherapy openly state that they use a blackbox approach that evaluates treatment methods by the evidence for their outcomes.
But yeah, i feel what you say about depression and material conditions. I'm absolutely not saying that does not have an impact. And i generally prefer to work with medical stuff that is aware of the intersection between mental health and such sociopolitical factors. One reason i stuck with my ergotherapist is that in our first session, she said that her aim is not to enable me to mask or assimilate better, but to give me tools for managing my ressources better and to enable me to choose when i apply them and when i focus more on things like self acceptance. Which is a big thing for ADHD treatment, especially in our society - a lot of patients first have to learn to be kind to themselves and not to constantly judge themselves as failures.
Eh, idk where i'm going with this. I think i'm digressing, But yeah, it absolutely eats at people's mental health to see where the world is headed. It's a dilemma that a lot of therapists are aware of. How do you treat somebody who suffers to a degree that is actually appropriate to an unbiased, sober and honest look at the conditions we live in? How much cope can you teach them before a survival tool becomes an enabler of accepting conditions that should be unacceptable? I don't have an easy answer for that. I absolutely would have broken by now if i would not have ways to manage the emotional toll that living in our world takes. I honestl wonder if it's enough or if i need ways to distance myself further to survive. I've seen with some dear friends where activist burnout leads, i don't want that kind of damage on top of everything else. But then there's this voice in my head that asks if this isn't a sacrifice we have to make for a better world when so many comrades have literally given their lifes already. It's a mess, frankly.
thank you for the thoughtful response. totally, therapeutic intervention that doesn't shy away from acknowledging material realities is always going to feel more honest and likely do more to help people like us. i found DBT to be great for this personally, polar opposite to the stuff you find in e.g. CBT. and that shit works. i didn't really have a point either, mostly just a lot of what you said struck a chord with me and i wanted to share my experience and struggle with this dialectic. philosophically the brain as a black box is frustrating to me but it is accurate. i am glad to hear you have been able to make progress and find help with your own struggles, despite the awful world outside. on my bad days those feel incompatible. but we have to struggle on as you say. solidarity comrade:)
I too have severely debilitating ADHD. Through grappling with it and also depressive episodes in my own life, I often wonder what it's like for people in poorer countries, or whether these are diseases of modern society. For psychological issues it's extremely hard to discern what is purely genetic and what is largely environmental/social.