wtf, meds by the day and weekly piss tests? Damn that’s brutal. Is it because of where you live or do they know about your drug history and just treat you like shit because of that?

That’s what really gets me: they’ll vilify someone using a harmless medicine in moderation for treatment purposes, but completely overlook people who get totally fucked up on alcohol on the regular. It’s so backwards. I avoided weed for decades until it was prescribed to me because “drugs are bad” and it didn’t take long after trying it to figure out what a ridiculous lie that is. Not all drugs are equal, and alcohol is worse than at least a few.

Lots of not accepting new patients and places that never end up calling me back even after multiple tries. Websites which specifically said they had availability were not accepting new patients when called. It’s exhausting.

If you are also in the US, I suspect the reason why is the looming threat from the DEA. Even if you are not a telemedicine patient, if your doctor’s office offers it as an option then they’re probably applying a blanket policy to everybody regardless. I hope they don’t treat you as badly as they did me. Depending on the doctor, they could still elect to allow your marijuana use. It just means if they get audited, they have to justify why they’re prescribing stimulants to a marijuana user. There is no reason not to and you have a long history of benefitting from the medication, so it should be clear cut. But the doctor may still decide it’s not worth the hassle or risk, like mine did.

Had I known ahead of time it might be a problem, I would have abstained as long as possible before the test (preferably over two weeks) and looked into detox drinks and other fast detox tricks. Worst that happens is I fail anyway and wind up right where I am now: needing to find a new doctor. But it could have saved me the trouble of needing to switch so soon. Maybe it can buy you some time.

I have a friend that helps me with some basic stuff, but in recent years they’ve gotten busier and more stressed, and I’m always going to have them put themselves first. They still help a lot, but it has gotten harder when they can’t help and I don’t get my own shit together. I’m embarrassed to admit how long it takes me to find a new doctor or therapist. I’ve never looked into an advocate, though. I don’t think I’d qualify, but I’ll definitely take a look, thanks!

I don’t think it’s a medical reason. If my cardiovascular health were at risk, stimulants alone would be a bad idea. I’m healthy enough and my usage is minimal. He tossed out some BS about working memory, but if I go down that rabbit hole this comment will get 5x as long.

The benefit of the doubt here is he’s covering his own ass. The DEA has been threatening to crack down on stimulant prescribers for a while, especially over telemedicine (which this was). If he gets audited and has to justify why he’s prescribing stimulants to a drug user, he could lose his medical license - or he may just not want to deal with the research and extra work needed to write up that justification.

To that end, it fucking sucks, but I can’t really blame him. I just wish he had been more honest and up front with me like I was with him. We could have waited a month to take the drug test and I’d have passed it, then this whole thing could have been avoided. Instead he looks down on me and repeatedly hasn’t truly listened to what I’ve told him. I won’t pass judgment on him the same way he did to me, but I will say his style is incompatible with me as a patient. I’m an active participant in my own care and I need a doctor who will form a collaborative relationship with me, not dictate treatment decisions.

Thankfully it’s not my GP, but yeah it’s time to find another provider and start all over again. I went looking for a psychiatrist to manage my meds for a different reason a month or two ago and struck out half a dozen times before running out of steam, so it’s a little easier said than done. I’ll get there eventually, just … it’s weirdly difficult to get help and executive dysfunction can be a real bitch. I won’t miss this provider though, so that’s some motivation!

Yes, I brought up that we already discussed the edibles. Given how long after use you can still test positive I told him the results probably wouldn’t change, and he straight up said that if I don’t stop using it entirely then he doesn’t want me as a patient. It felt so judgmental, and that part of it really upsets me too. I promise I’m not that exciting lol

Sorry about your medication mix up. Every time they have me update my info it has a list of all the meds I’m taking and I’m supposed to correct any dosages that have changed or cross them out if I no longer take them. Every time I cross out the same ones and re-correct the dosages again. My file has a totally different picture from reality - it’s kinda scary.

Live content has lots of downtime and dull gameplay moments. It can’t compete with polished, edited videos - except in the one area it shines: human interaction. That works better when you can see the person. So most streams feature a person or at least an avatar, while edited videos often place a higher emphasis on gameplay. Each format is simply playing to its strengths. The ones that don’t you rarely see because they’re buried at the bottom of page 726 with four views.

I try to minimize what I buy off Amazon, but I allow myself one bag of Frugra per month because I can’t get it any other way.

This is the quintessential McDonald’s experience. Every time I give in to that random pang of nostalgia, I know I’m in for some kind of disappointment. It might be a broken ice cream machine, an item that’s just out that day or been removed from the menu permanently, or something as mundane as having my order screwed up. In that, ironically, it rarely disappoints.

That’ll be $28.73 at the second window.

I don’t have a source handy, but from what I remember: yes, a feral child can learn language later, but never to the same level of fluency. It’s more like learning a second language. Also there is extremely limited data because it mostly comes from horrifically abusive situations.

If I remember right, the most interesting data came from a study that gathered deaf children from areas where they had no sign language. The young children rapidly developed sign language, but the older children (teens) had a hard time keeping up and did not reach the same fluency.

The term narcissist is somewhat overused, though there are also a lot of them these days. To echo a bit of what others said, thinking average high schoolers are dumb is not a sign of narcissism. Average high schoolers are notoriously foolish. Even if you feel like it’s more than that and it’s a serious problem, that alone does not make a narcissist.

Actual narcissists are unstable. They need the adoration of others to feel good about themselves. They’re prone to fits of rage when anything damages their ego, and they can take just about anything as criticism then decide to fly off the handle.

If that is you, get help from a professional who specializes in it. If anyone reading this knows a person like that, read up and find a way to save yourself.

Well, I hope this wall of text helps at least one person. For you or anyone else who needs this and happens to find it: yes. There are many treatments beyond traditional antidepressants that are only a last resort because insurance is a pain in the dick. All of them are different methods of increasing neuroplasticity, making it easier to form new neural pathways instead of staying stuck in the same “comfortable” depression. It’s like depressive thoughts are a paved sidewalk and happy, healthy thoughts are overgrown, covered with branches and weeds. With enough persistent effort you might be able to clear out that other path, but it’s a hell of a lot easier if someone clears out all the weeds first and gives you a machete. That’s neuroplasticity with appropriate therapy.

The main treatments available are ketamine (IV), Spravato (ketamine nasal spray), ketamine troches, TMS (transcranial magnetic stimulation), and psilocybin (still illegal in most places). I can give details on each, but specifics will likely vary a bit by treatment center.

• IV ketamine therapy

is guided therapy while under the influence of IV ketamine. It’s the most helpful form of ketamine. Both the dosing and therapy are more targeted. The therapy part may be covered by insurance, but the ketamine rarely is and that runs roughly $400 a dose. Sessions are once a month.

• Spravato

is well covered by insurance because they were able to patent it. That also means it’s slightly different: it’s only the S-ketamine enantiomer as opposed to racemic ketamine, which is a racemic mixture of both S- and R-ketamine enantiomers. Studies funded by the drug company say that’s better. Other studies are less clear. But really, there’s just far less data in general because it’s new. Treatment centers may vary, but mine just put me in a room with no guidance or therapy and had me do drugs.

I knew how to make the most of it anyway, but I felt really bad for the people who expect it to work like other medications they can just take and they feel better. You need to actually form the new pathways during the state of increased neuroplasticity. If you go this route, make sure you have a therapist appointment the day after treatment, preferably with a therapist who is familiar with it. Treatments are twice a week for the first month and once a week after. Each one lasts about two hours and must be done at the clinic.

• Oral ketamine troches

are not usually covered by insurance, but they are relatively affordable at $50-75 a month. You may have to shop around to find a compounding pharmacy that can ship to your state (if US) at that price. Ketamine is poorly absorbed when taken sublingually so the dosage is much higher and the side effects may be worse. However, in my case I had fewer side effects once I found a good routine. Even though the troches are affordable, you still need to check in with the doctor every month. If insurance won’t cover that it will probably be almost as much as IV therapy. Some therapists are willing to do telehealth therapy with you during treatment so you can have guided therapy.

In the interest of being as informative as possible for anyone that finds this: studies show similar rates of absorption between oral troches and suppositories, but anecdotally some patients report a greater effect from melting their oral troches and boofing them. You can find instructions for doing this with opiates and the process is similar. The troche just needs a bit of heat to melt it. A hair dryer or holding the (capped) syringe under hot water will work. Anecdotally, this does seem more effective and was a lot easier than trying to hold the troche under my tongue.

• TMS

is well studied, non-invasive, has a high rate of success, and is usually covered by insurance. Treatments are only a few minutes, but you need to go in four times a week. It’s like Spravato in that you will get the most benefit if you’re actively working with a therapist to take advantage of the increased neuroplasticity.

• Psilocybin

is probably illegal where you live. Studies are extremely limited because drug laws make it difficult, but the data we do have is extremely promising - moreso than ketamine. The only reason we do ketamine instead is it’s already used as an anesthetic, so using it for depression is just off-label, which doctors do all the time. There is a push to legalize psilocybin for treating depression, but it’ll still be a while. Until then, you have to either obtain it illegally or grow your own mushrooms (illegally).

When using mushrooms, state of mind and a comfortable setting are most important. If possible, be with someone who knows you and can keep you calm if you get anxious. Some people - especially those with severe mental illness and/or a genetic predisposition to one, such as schizophrenia - may have a bad reaction, sorta like how any medication has rare side effects and some people just get the fun of being especially unique. But for most people, the experience can be profound and life changing. Some may snap out of depression after a single dose, others may need regular treatments every couple months. Unfortunately, drug laws limit both the data and the accessibility of this treatment. However, it has the potential to be the most effective and the most affordable.

There is hope. Your depression can be cured. You can feel alive and content and so many other emotions again.

If there are questions, feel free to ask, but I don’t know if I get notifications so I may not see it. I have not personally done IV ketamine or TMS, but I have read up on them and gone over the details with a doctor when discussing treatment options.

Hell make it where I can go online fill in all my information and automatically every time voting is taken place in my area I received a package in the mail. We fill it out vote and mail it back.

This is exactly how it works in Washington state. You get the ballot in the mail, fill it out, seal it up, and mail it back or drop it off in a drop box. It’s worked great for years.

Steins;Gate. It starts slow, but once it picks up it’s amazing and puts all that slow build up to good use. Not sure if it technically counts though. Visual novels are a weird middle ground that aren’t really book or game, but there are some really good ones. Definitely the way to go if you’re in more of a reading mood but want some art and music to go with it.

Seconding Etymotic. And if you wanted to upgrade later, you can get custom ear molds from an audiologist and use those instead of the included foam or rubber tips. It’s among the best sound isolation you can get. I’ve also always had excellent experiences with their customer service.