I have had issues with depression and focus for most of my life.

I first noticed it when I was thirteen, my thirteenth birthday in fact, when I suddenly stopped being able to focus on doing my homework. I was a perpetual frustration to my teachers, since I was active in class, and I was clearly learning the material, but I wouldn’t do my homework, and they’d be forced to give me a bad grade. I hold no grudges about that, they did what they had to do, they can’t really bend the rules for one person.

It’s been an issue that has persisted. I’m thirty-four years old now, and I’m still having issues with focus and depression. I’ve been fired from multiple jobs, gotten bad performance reviews, alienated “corporate friends”, and all because I don’t really know how to focus on work. Sometimes I am able to buckle down, get enough work done to avoid getting fired, and even got promoted once, but these are outliers.

I wish I know why I managed to be successful in some jobs and not in others. It’s not a “fun factor” either; I’ve been fired from jobs that were, by all accounts, very good, and I still can’t focus, and I’ve also done well in jobs I hate. It’s dumb.

I felt like there might be some value in documenting my history with different medications. I’m not sure why I think that, but it feels true and it doesn’t cost me anything to try.

Wellbutrin and Lamictal.

So because of all of this, I’ve been on some forms of mediction since 2017. I started with Wellbutrin and Lamictal, because my doctor thought I might have Bipolar II. I’m not completely sure why he thought that, since I don’t really get “manic”, but he’s more qualified to make these distinctions than I am, so I’m sure he had his reasons.

Anyway, for about a year, that combination genuinely felt like a miracle drug. I was able to get things done at work, I was having fun at work, and I consider that period of my life to be one of my best. I didn’t really have any side effects, and everything felt like it was working out well.

After a year, almost overnight, this cocktail of meds stopped doing anything. I fell into my old habits, I couldn’t focus on work, I started feeling bad about myself, and I was deeply unhappy most of the time. I went on and off the Wellbutrin and Lamictal combo several times for the next two years, and it felt like I did absolutely nothing.

On the bright side, there weren’t really any side effects; with the exception of Wellbutrin keeping me up all night if I took it too late in the day, it was relatively easy to take these meds.

Abilify

Eventually, in 2022, I decided to ask my doctor if I could try other drugs. I explained to him that what we were doing was clearly not working, and something needed to change, and he agreed.

He tried putting me on “Abilify”, which is typically prescribed as an antipsychotic. I’m not psychotic, but Abilify is also prescribed off-label for clinical depression, and its effects are supposed to work fairly quickly, so we figured it was worth a shot.

Abilify was weird. It gave me strange tremors in my right hand, which is extremely scary and made me afraid I was going to get that disease from Awakenings, but at least that went away after a week. What was more concerning was how easy it was to self-justify spending large quantities of money.

Within one weekend I spent over a thousand dollars on different types of software. I bought the professional version of Toonboom Harmony, Paintstorm, Corel Painter, and a few other programs. I was convinced I was going to learn to do digital art. I never did, it was a waste of money.

Ability didn’t really work for me. It didn’t really stop my depression, it didn’t help my focus, and it made me spend all my money, so I asked my doctor to take me off.

Lexapro

After the failure of Abilify, I needed to try another medication. I decided to try venturing into the world of SSRIs, since it was a type of drug that I hadn’t tried yet.

There’s not a lot to say about Lexapro. Unsurprisingly, it didn’t really help my depression, and it ended up giving me pretty severe anorgasmia, which was very frustrating after a few days. Seriously, it might not sound like a big deal but it’s extremely distracting after about a week of being “pent up”, as it were.

Adderall and Vyvanse

In August 2022, I got new insurance and thus a new psychiatrist, because American health insurance is annoying. This new doctor felt that I might have ADHD, which was not much of a surprise to me, since my issues appeared to be focus-based. This doctor recommended I try a stimulant-based medication, and I figure it’s worth a shot.

Anyone trying to get Adderall around that time, however, probably remembers that this was actually during a national Adderall shortage, meaning it was actually kind of a pain in the ass to get. I tried six different pharmacies in my area and two different pill delivery services until I was able to get ahold of it.

Adderall didn’t really help my focus, which surprised me a lot. I had seen portrayals of Adderall on TV, and it looked like people were hyper-productive with it, and I didn’t feel a lot of positive things. I had all the negatives, however.

First, it dried my mouth out pretty tremendously, making me perpetually thirsty. I remember I finished an entire two liter bottle of Diet Coke in less than thirty minutes, and I didn’t even realize it until it was gone. It also really disrupted my sleep. Even when I took the meds at six in the morning, it was extremely difficult to get to sleep, even relatively late at night. It was horrible: not getting sleep makes everything in life worse.

The doctor thought that I might benefit from an extended-release stimulant, and thus they prescribed my Vyvanse.

Vyvanse didn’t really help either, but at least it didn’t really have any side effects. There’s not a lot to say about it.

Intuniv

When I complained that I really hated the stimulant-based drugs, I asked my doctor if there were any other meds that can help with focus so they then prescribed Intuniv. It’s is generally not prescribed to adults for attention disorders, but it is occasionally prescribed for that off-label.

Intuniv has the advantage of being kind of the opposite of Adderall; it is often used as a sleep aid, and it’s recommended that you start taking it at night as a result.

Other than some drowsiness in the beginning, I haven’t noticed a lot of side effects from the Intuniv. It also seemed to actually work, if only a little.

For the first time in awhile, it felt like I was able to actually accomplish things at work, at least sometimes.

I’m still on Intuniv, so take that for what it is.

Pristiq

While my focus was slightly better, I was still feeling depressed. I would get into spirals of feeling extreme guilt, and feeling bad about myself, which still affected most other aspects of my life negatively.

The doctor figured that Pristiq, an SNRI instead of an SSRI.

It actually seemed to work slightly. I felt like I was doing a bit better, I would stop getting into spirals of guilt over stuff and I was a bit more productive.

I’m also still on Pristiq

TMS

Not a “medication”, but still a treatment.

Pristiq was helping, but it would come in waves. There would still be relatively long periods of feeling bad about myself, just less frequently. Since my insurance covered it, I decided to give TMS a shot.

TMS is effectively a treatment where they zap your head with magnets for about twenty minutes a day, thirty-five times.

During the treatment, it hurt a little. It kind of felt like something poking my temple relatively hard. It also made me really tired throughout the rest of the day, especially in the beginning.

It’s been about four months since the last treatment, and I don’t think TMS did anything at all. I think it was a waste of time.

Sleep Apnea Oral Appliance

Again, not a medication but figured I might as well post this.

One of my doctors felt like it might be worth looking into if I have any sleep issues, as that can often manifest itself as depression or ADHD in adults. I already knew that I snored and my wife said I had really disturbing and scary breathing sometimes, so I agreed with the doctor.

I had myself tested, and it turned out that I do, indeed, have moderate sleep apnea. On average, I wake up about sixteen times an hour every night. Fortunately, I have minor enough apnea to not require a CPAP; I was able to get away with an extremely expensive oral appliance.

Since I’ve been wearing that every night, it does feel like I’m getting better sleep. My wife says I’m not snoring at all anymore, and my breathing seems normal, so this is almost certainly an improvement. I still have my focus issues, but I’ve been waking up feeling more rested.

Conclusion

As of right now, I’m on Wellbutrin, Lamictal, Intuniv, and Pristiq. I’m a bit worried that none of them are going to work long-term, but I guess all I can do is keep trying. Hopefully something eventually sticks.