Disclaimer: I am not a doctor and this is not medical advice. Do your own research.
In short: I experienced something similar. Garrett and I call it “Rat(ionalist) Depression.” It manifested as similar to a loss/lessening of Will To Wizard Power as John uses the term here. Importantly: I wasn’t “sad”, or pessimistic about the future (AI risk aside,) or most other classical signs of depression; I was considered pretty well emotionally put-together by myself and my friends (throughout, and this has never stopped being true.) But at some point for reasons unclear to me, I became listless. The many projects of a similar flavor to things John points at above, which I used do to in spades, lost their visceral appeal (though they kept their cognitive/aesthetic/non-visceral appeal and so compelled me to force myself now and then to some success but also some discomfort and cognitive dissonance)-- and it happened gradually so that it seemed like a natural development over a year or two.
My girlfriend, who is on Bupropion for regular physician-recognized depression, encouraged me to try it just to see. So I did. And it worked.
And it kicks in very quickly. There was a honeymoon phase during the first ~8 days it takes for all of the long half-lived active metabolites to reach equilibrium concentrations, during which I and others I know have reported feeling mild euphoria along with the other benefits. After that subsides, it’s a background thing where mostly you look back on your day/week and realize you just got things done and did more things. And it’s been consistently helpful ever since. (4-6 months for me, ~7 years for my girlfriend, years for some family members and somewhat less time so far for others I know personally.)
Oh and my social battery is way larger. I used to get introvert-exhaustion in a way that ~basically doesn’t happen anymore. Parties are more often fun than not, now.
Further nice-to-haves:
It’s not an SSRI, it’s an NDRI, so it doesn’t do the terrible SSRI things. Side effects may include decreased mental fog, increased libido, decreased appetite, and a renewed will to Wizard Power.
You’ll “feel it” right away (~same day) even though it takes a ~week to settle in to equilibrium concentrations (and, anecdotally from others, possibly up to month to feel it’s final form?)
It’s fairly easy to get. Go to your psychiatrist and ask for it (XR, extended release to be taken in the morning) or trade time/convenience for money and go online to a site like Nurx.com and if, upon completing their intake survey, they consider you to have mild depression (not severe or you’ll scare them off) they’ll start mailing you bupropion once a month!
It doesn’t work for literally everyone. If you have bad anxiety, or if you have mania, be warned. But for the large handful of people around me who are now on it, they’ve reported fast and significant positive effects, including at least one other “Rat Depression” case.
Took buproprion for years and while it did help with executive function, I was also half-insane that entire time (literal years from like 2015 to 2021). I guess it was hypomania? And to expand on ‘half-insane’ - one aspect of what I mean is was far too willing to accept ideas on a dime, and accepted background assumptions conspiracy theories made while only questioning their explicit claims. Misinformation feels like information! Overall there was a lack of sense of grounding to base conclusions on in the first place. I will note this still describes me somewhat, but not nearly as bad. Although it is a bit hard to pin down how much of that was a lack of tools and knowledge, a lot of it was an inability to calm down and rest. A brain constantly on the edge of exhaustion and constantly trying to push is in no state to think coherently.
Buproprion also made my anxiety significantly worse—I attribute most of the panic attacks in my life to it. But all this was very hard to notice due to college stress, and after taking it long enough I had just just attributed it to my base personality + existential despair from learning AI risk.
My overall positive experience from it was that it felt like a stronger caffeine.
What ultimately helped depression (not cured but way improved) was * transitioning to female (estrogen in particular has strong positive effects for me within hours, but only when taken via the buccal or sublingual route instead of orally) * stopping buproprion—was frankly not good for my brain for multiple reasons (some listed here) * adderall to treat my (unknown to me until ~2022) ADHD * graduating college and then not having constant stress from college or work deadlines * learning to genuinely rest and enjoy doing nothing (stopping buproprion helped a lot with this). * not constantly trying to come up with ideas and write expansions of them (this behavior mostly stopped when buproprion stopped as well, actually) * eating better (beef in particular is extremely important for some unknown reason) * doing physical therapy to fix upper and lower cross syndrome (took a long time to identify) - sleep is better, less constant muscle tension while laying down * working less than 20 hours a week. (More than that isn’t sustainable for me) * letting my activity be primarily driven by projects shaped like dopamine trails that spawn further dopamine trails instead of todo lists and dependency trees. Where I define 95% of what needs to happen in the moment as a reaction to the shiny thing in front of me—just one more interesting idea to implement this one tiny thing. Contrasted to the next awful task being handed down from various bigger todo lists. * 4 days totally off for every ~8 of work (2 days off is never restful and I have multi-day momentum where I don’t want to stop working on projects) * immense sense of calm safety while cuddling girlfriend (decreases my anxiety an absurd degree)
Also dropping the autistic masking. I didn’t think I did any of this since I’d known I was autistic since gradeschool, and thought I’d actively fought anything shaped like ‘being normal’. The kind of masking was people pleasing—I hadn’t even realized I was doing it so hard. It was completely and utterly out of control. I would simulate conversation trees to notice what things I might say that would induce stress in people, and then explicitly avoid saying those things later. I was unable to intentionally choose to induce stress in another person, and as it turns out that is a massive liability in fact. Because it means anything shaped like being slightly mean on purpose in your personality gets implicitly erased. Which is in fact traumatizing. Or any needs you have that require causing someone a bit of stress just don’t get met. It requires an unending quantity of input energy to accomplish, more and more as you get better at noticing what induces stress and contorting to avoid it. Never intentionally doing harm is completely untenable. It is an utterly unrealistic standard to hold oneself to. One has to intentionally induce some number of harms one is aware of causing beforehand.
But in doing so there’s suddenly room to breathe and live.
I’m very glad you’re in a better place now! It sounds like there was a lot going on for you and agree that, in circumstances like yours, bupropion is probably not the right starting point.
As a doctor, I can tell you that even if you don’t have anxiety, it’s possible to develop some while taking bupropion/welbutrin. I used it personally and experienced the most severe anxiety I’ve ever had. It is also associated with a higher chance of seizures, and if you daydream a lot, it may make them worse. However, on the positive side, it often decreases inattention. Generally i like the drug , but it is not a first-line treatment for depression, and for good reasons.
The wikipedia side-effect page says that the rate of seizures is between 0.01-0.1%, for comparison about 0.68% of the population has epilepsy, so I’m skeptical this ought to be such a concern. Am I reading these numbers incorrectly?
I can definitely believe the anxiety bit. It is a stimulant, and anxiety & depression are very very correlated.
People with a history of seizures are usually excluded from these kinds of clinical trials, so it is not an apple to apple comparison. the problem is that bupropion interacts with a lot of drugs. seizure rates are also highly dose dependent(10 times higher if taking more than 450 mg daily). Generally, if you’re not taking any interacting medications, are on the 150–300 mg slow-release version, and have no history of seizures, then the risk is low.
Could you elaborate on the daydreaming? I think it might have gotten worse for me, although it was already pretty bad. I was hoping Bupropion would reduce it but if it has the opposite effect it might have been a bad idea to start taking it...
Reporting back in after having laid hands on some bupropion. I’m two days in and:
it’s definitely doing anything helpful with respect to my senses of opportunity, pointfulness, allowedness/permission, and task initiation/switching/completion, among other subtle senses
it meshes just fine with my focus meds so far
the increase in anxiety has been real but thus far manageable
but also there’s some weird effect where it’s making me way more forgetful/absent-minded by way of that massively improved power at task-initiation and task-switching and sharpness of task-completion? I’ve already nearly mislaid things like pens, a pocket knife, my phone, assorted drinks.… and such because I set it down, finished a task, and then moved on to the next task
weak improvement to hedonic tone mostly flavored like ~internal burning/dynamoness? in a good way
Do you have an indications that those without the clinical signs of depression (or at least doctor approved state) won’t become acclimated to the drug in a way those that perhaps need it for a balanced state don’t?
I suppose asking a bit differently here, what are the gears here that do the work and how well one might think they they match up with one’s own system that is in place?
Interesting though about using it to improve one’s performance rather than just as an antidepressant or aid to quit smoking. the wiki has some good info but interesting that it doesn’t have a strong effect on dopamine so makes me wonder if looking more at what norepinephrine does, or perhaps the ratio between norepinephrine and dopamine.
Any consideration on the use of other NDRI drugs rather than Bupropion. I’ve not looked into much at this point but Bupropion does have some side effects I would not be too interested in experiencing.
Interesting though about using it to improve one’s performance rather than just as an antidepressant or aid to quit smoking.
IIUC the model here is that “Rat Depression” in fact is just depression (see downthread), so the idea is to use bupropion as just an antidepressant. The hypothesis is that basically-physiologically-ordinary depression displays differently in someone who e.g. already has the skills to notice when their emotions don’t reflect reality, already has the reality-tracking meta-habits which generate CBT-like moves naturally, has relatively weak emotions in general or habitually decouples from their emotions, etc.
I don’t think there’s only one type of depression. Major head trauma does lead to depression in a good portion of people.
It’s my impression Bupropion seems to make it easier to break out of patterns that bind your behavior. That’s true whether that’s smoking (which is why Bupropion is used to help people to stop smoking) or some patterns that contribute to depression.
Bupropion seems to treat akrasia, which is a major part of a lot of “Rat depression”.
Bupoprion is used to help people stop smoking because it is in the same class of molecule as nicotine and triggers many of the same receptors. I wouldn’t expect it to help any other addiction as well as it treats smoking.
Disclaimer: I am not a doctor and this is not medical advice. Do your own research.
In short: I experienced something similar. Garrett and I call it “Rat(ionalist) Depression.” It manifested as similar to a loss/lessening of Will To Wizard Power as John uses the term here. Importantly: I wasn’t “sad”, or pessimistic about the future (AI risk aside,) or most other classical signs of depression; I was considered pretty well emotionally put-together by myself and my friends (throughout, and this has never stopped being true.) But at some point for reasons unclear to me, I became listless. The many projects of a similar flavor to things John points at above, which I used do to in spades, lost their visceral appeal (though they kept their cognitive/aesthetic/non-visceral appeal and so compelled me to force myself now and then to some success but also some discomfort and cognitive dissonance)-- and it happened gradually so that it seemed like a natural development over a year or two.
My girlfriend, who is on Bupropion for regular physician-recognized depression, encouraged me to try it just to see. So I did. And it worked.
And it kicks in very quickly. There was a honeymoon phase during the first ~8 days it takes for all of the long half-lived active metabolites to reach equilibrium concentrations, during which I and others I know have reported feeling mild euphoria along with the other benefits. After that subsides, it’s a background thing where mostly you look back on your day/week and realize you just got things done and did more things. And it’s been consistently helpful ever since. (4-6 months for me, ~7 years for my girlfriend, years for some family members and somewhat less time so far for others I know personally.)
Oh and my social battery is way larger. I used to get introvert-exhaustion in a way that ~basically doesn’t happen anymore. Parties are more often fun than not, now.
Further nice-to-haves:
It’s not an SSRI, it’s an NDRI, so it doesn’t do the terrible SSRI things. Side effects may include decreased mental fog, increased libido, decreased appetite, and a renewed will to Wizard Power.
You’ll “feel it” right away (~same day) even though it takes a ~week to settle in to equilibrium concentrations (and, anecdotally from others, possibly up to month to feel it’s final form?)
It’s fairly easy to get. Go to your psychiatrist and ask for it (XR, extended release to be taken in the morning) or trade time/convenience for money and go online to a site like Nurx.com and if, upon completing their intake survey, they consider you to have mild depression (not severe or you’ll scare them off) they’ll start mailing you bupropion once a month!
It doesn’t work for literally everyone. If you have bad anxiety, or if you have mania, be warned. But for the large handful of people around me who are now on it, they’ve reported fast and significant positive effects, including at least one other “Rat Depression” case.
That’s most of the pitch.
Took buproprion for years and while it did help with executive function, I was also half-insane that entire time (literal years from like 2015 to 2021). I guess it was hypomania? And to expand on ‘half-insane’ - one aspect of what I mean is was far too willing to accept ideas on a dime, and accepted background assumptions conspiracy theories made while only questioning their explicit claims. Misinformation feels like information! Overall there was a lack of sense of grounding to base conclusions on in the first place. I will note this still describes me somewhat, but not nearly as bad. Although it is a bit hard to pin down how much of that was a lack of tools and knowledge, a lot of it was an inability to calm down and rest. A brain constantly on the edge of exhaustion and constantly trying to push is in no state to think coherently.
Buproprion also made my anxiety significantly worse—I attribute most of the panic attacks in my life to it. But all this was very hard to notice due to college stress, and after taking it long enough I had just just attributed it to my base personality + existential despair from learning AI risk.
My overall positive experience from it was that it felt like a stronger caffeine.
What ultimately helped depression (not cured but way improved) was
* transitioning to female (estrogen in particular has strong positive effects for me within hours, but only when taken via the buccal or sublingual route instead of orally)
* stopping buproprion—was frankly not good for my brain for multiple reasons (some listed here)
* adderall to treat my (unknown to me until ~2022) ADHD
* graduating college and then not having constant stress from college or work deadlines
* learning to genuinely rest and enjoy doing nothing (stopping buproprion helped a lot with this).
* not constantly trying to come up with ideas and write expansions of them (this behavior mostly stopped when buproprion stopped as well, actually)
* eating better (beef in particular is extremely important for some unknown reason)
* doing physical therapy to fix upper and lower cross syndrome (took a long time to identify) - sleep is better, less constant muscle tension while laying down
* working less than 20 hours a week. (More than that isn’t sustainable for me)
* letting my activity be primarily driven by projects shaped like dopamine trails that spawn further dopamine trails instead of todo lists and dependency trees. Where I define 95% of what needs to happen in the moment as a reaction to the shiny thing in front of me—just one more interesting idea to implement this one tiny thing. Contrasted to the next awful task being handed down from various bigger todo lists.
* 4 days totally off for every ~8 of work (2 days off is never restful and I have multi-day momentum where I don’t want to stop working on projects)
* immense sense of calm safety while cuddling girlfriend (decreases my anxiety an absurd degree)
Also dropping the autistic masking. I didn’t think I did any of this since I’d known I was autistic since gradeschool, and thought I’d actively fought anything shaped like ‘being normal’. The kind of masking was people pleasing—I hadn’t even realized I was doing it so hard. It was completely and utterly out of control. I would simulate conversation trees to notice what things I might say that would induce stress in people, and then explicitly avoid saying those things later. I was unable to intentionally choose to induce stress in another person, and as it turns out that is a massive liability in fact. Because it means anything shaped like being slightly mean on purpose in your personality gets implicitly erased. Which is in fact traumatizing. Or any needs you have that require causing someone a bit of stress just don’t get met. It requires an unending quantity of input energy to accomplish, more and more as you get better at noticing what induces stress and contorting to avoid it. Never intentionally doing harm is completely untenable. It is an utterly unrealistic standard to hold oneself to. One has to intentionally induce some number of harms one is aware of causing beforehand.
But in doing so there’s suddenly room to breathe and live.
I’m very glad you’re in a better place now! It sounds like there was a lot going on for you and agree that, in circumstances like yours, bupropion is probably not the right starting point.
As a doctor, I can tell you that even if you don’t have anxiety, it’s possible to develop some while taking bupropion/welbutrin. I used it personally and experienced the most severe anxiety I’ve ever had. It is also associated with a higher chance of seizures, and if you daydream a lot, it may make them worse. However, on the positive side, it often decreases inattention. Generally i like the drug , but it is not a first-line treatment for depression, and for good reasons.
The wikipedia side-effect page says that the rate of seizures is between 0.01-0.1%, for comparison about 0.68% of the population has epilepsy, so I’m skeptical this ought to be such a concern. Am I reading these numbers incorrectly?
I can definitely believe the anxiety bit. It is a stimulant, and anxiety & depression are very very correlated.
People with a history of seizures are usually excluded from these kinds of clinical trials, so it is not an apple to apple comparison. the problem is that bupropion interacts with a lot of drugs. seizure rates are also highly dose dependent(10 times higher if taking more than 450 mg daily). Generally, if you’re not taking any interacting medications, are on the 150–300 mg slow-release version, and have no history of seizures, then the risk is low.
Yeah, I figured something like that would be going on if I was wrong, thanks!
Could you elaborate on the daydreaming? I think it might have gotten worse for me, although it was already pretty bad. I was hoping Bupropion would reduce it but if it has the opposite effect it might have been a bad idea to start taking it...
I also had a pretty similar experience.
Reporting back in after having laid hands on some bupropion. I’m two days in and:
it’s definitely doing anything helpful with respect to my senses of opportunity, pointfulness, allowedness/permission, and task initiation/switching/completion, among other subtle senses
it meshes just fine with my focus meds so far
the increase in anxiety has been real but thus far manageable
but also there’s some weird effect where it’s making me way more forgetful/absent-minded by way of that massively improved power at task-initiation and task-switching and sharpness of task-completion? I’ve already nearly mislaid things like pens, a pocket knife, my phone, assorted drinks.… and such because I set it down, finished a task, and then moved on to the next task
weak improvement to hedonic tone mostly flavored like ~internal burning/dynamoness? in a good way
More to come, maybe.
Do you have an indications that those without the clinical signs of depression (or at least doctor approved state) won’t become acclimated to the drug in a way those that perhaps need it for a balanced state don’t?
I suppose asking a bit differently here, what are the gears here that do the work and how well one might think they they match up with one’s own system that is in place?
Interesting though about using it to improve one’s performance rather than just as an antidepressant or aid to quit smoking. the wiki has some good info but interesting that it doesn’t have a strong effect on dopamine so makes me wonder if looking more at what norepinephrine does, or perhaps the ratio between norepinephrine and dopamine.
Any consideration on the use of other NDRI drugs rather than Bupropion. I’ve not looked into much at this point but Bupropion does have some side effects I would not be too interested in experiencing.
IIUC the model here is that “Rat Depression” in fact is just depression (see downthread), so the idea is to use bupropion as just an antidepressant. The hypothesis is that basically-physiologically-ordinary depression displays differently in someone who e.g. already has the skills to notice when their emotions don’t reflect reality, already has the reality-tracking meta-habits which generate CBT-like moves naturally, has relatively weak emotions in general or habitually decouples from their emotions, etc.
I don’t think there’s only one type of depression. Major head trauma does lead to depression in a good portion of people.
It’s my impression Bupropion seems to make it easier to break out of patterns that bind your behavior. That’s true whether that’s smoking (which is why Bupropion is used to help people to stop smoking) or some patterns that contribute to depression.
Bupropion seems to treat akrasia, which is a major part of a lot of “Rat depression”.
Bupoprion is used to help people stop smoking because it is in the same class of molecule as nicotine and triggers many of the same receptors. I wouldn’t expect it to help any other addiction as well as it treats smoking.