SleepyCatten<p>Hey folks 👋</p><p>For those who don't already know, we're currently signed off work due to depression, anxiety, and burnout.</p><p>Our employer is supportive, but there are multiple, fundamental, ongoing issues with the organisation that no amount of individual support can resolve. We cannot go into more detail.</p><p>During the last 2 and a bit weeks, we've done a mixture of resting and doing tasks we've been meaning to do for ages, but neither had the time nor spoons to do.</p><p>We're still on 200 mg <a href="https://en.wikipedia.org/wiki/Sertraline" rel="nofollow noopener noreferrer" target="_blank">sertraline</a> (an <a href="https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_inhibitor" rel="nofollow noopener noreferrer" target="_blank">SSRI</a>) daily, but we've made the switch from taking 150 mg <a href="https://en.wikipedia.org/wiki/Bupropion" rel="nofollow noopener noreferrer" target="_blank">bupropion</a> (an <a href="https://en.wikipedia.org/wiki/Norepinephrine%E2%80%93dopamine_reuptake_inhibitor" rel="nofollow noopener noreferrer" target="_blank">NDRI</a>) daily alongside to 40 mg <a href="https://en.wikipedia.org/wiki/Atomoxetine" rel="nofollow noopener noreferrer" target="_blank">atomoxetine</a> (an <a href="https://en.wikipedia.org/wiki/Selective_norepinephrine_reuptake_inhibitor" rel="nofollow noopener noreferrer" target="_blank">sNRI</a>, not an <a href="https://en.wikipedia.org/wiki/Serotonin%E2%80%93norepinephrine_reuptake_inhibitor" rel="nofollow noopener noreferrer" target="_blank">SNRI</a>) daily alongside. We're slowly titrating up to the recommend 80 mg dose. </p><p>As we came off the bupropion steadily, we definitely felt it (i.e., mood; executive function; energy etc.), but the effects are levelling off as our atomoxetine dose steadily increases.</p><p>The bupropion had helped us for a while, both with our mental health and some ADHD struggles, but could only do so much. As such, we decided to make the unorthodox switch to atomoxetine.</p><p>Bupropion is an atypical NDRI and antidepressant: it boosts noradrenaline and dopamine (to a lesser extent). However, it's only prescribed off licence for ADHD, as it's not been shown to be effective. Atomoxetine, conversely, is mainly used to treat ADHD in people who do not respond well to stimulants, such as <a href="https://en.wikipedia.org/wiki/Methylphenidate" rel="nofollow noopener noreferrer" target="_blank">methylphenidate</a>. It directly boosts noradrenaline and indirectly boosts dopamine in the prefrontal cortex by a decent amount.</p><p>Since we do not tolerate any stimulants well (even caffeine), atomoxetine is our best bet in terms of an ADHD med that also helps with our mental health.</p><p>Unlike bupropion, it doesn't have any major interactions with sertraline (only moderate), and we can take 40 mg <a href="https://en.wikipedia.org/wiki/Propranolol" rel="nofollow noopener noreferrer" target="_blank">propranolol</a> tablets alongside to help keep our anxiety under control, rather than turning straight to 10 mg <a href="https://en.wikipedia.org/wiki/Diazepam" rel="nofollow noopener noreferrer" target="_blank">diazepam</a> tablets. </p><p>So far, we're doing well with the switch, both physically and mentally, but it'll be a while before we know for sure whether this the ideal medication combination.</p><p>We are still very much in low power recovery mode, so don't expect anything much or consistent from us.</p><p>A last note to sign this off: from the above listed drugs, the only one we can currently get via the NHS is sertraline. We may be able to get atomoxetine through the NHS in the future, but that's dependent on us ever actually getting a formal ADHD diagnosis 😮💨 The waiting lists are rather long... even when using the <a href="https://www.nhs.uk/mental-health/social-care-and-your-rights/how-to-access-mental-health-services/#choice" rel="nofollow noopener noreferrer" target="_blank">Right To Choose</a> a mental health service provider.</p><p>Apologies for any typos.</p><p><a href="https://cultofshiv.wtf/tags/MentalHealth" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>MentalHealth</span></a> <a href="https://cultofshiv.wtf/tags/depression" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>depression</span></a> <a href="https://cultofshiv.wtf/tags/anxiety" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>anxiety</span></a> <a href="https://cultofshiv.wtf/tags/burnout" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>burnout</span></a> <a href="https://cultofshiv.wtf/tags/neurodivergent" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>neurodivergent</span></a> <a href="https://cultofshiv.wtf/tags/ADHD" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>ADHD</span></a> <a href="https://cultofshiv.wtf/tags/AuDHD" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>AuDHD</span></a> <a href="https://cultofshiv.wtf/tags/NHS" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>NHS</span></a> <a href="https://cultofshiv.wtf/tags/NHSEngland" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>NHSEngland</span></a> <a href="https://cultofshiv.wtf/tags/sertraline" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>sertraline</span></a> <a href="https://cultofshiv.wtf/tags/SSRI" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>SSRI</span></a> <a href="https://cultofshiv.wtf/tags/bupropion" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>bupropion</span></a> <a href="https://cultofshiv.wtf/tags/NDRI" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>NDRI</span></a> <a href="https://cultofshiv.wtf/tags/atomoxetine" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>atomoxetine</span></a> <a href="https://cultofshiv.wtf/tags/sNRI" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>sNRI</span></a> <a href="https://cultofshiv.wtf/tags/serotonin" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>serotonin</span></a> <a href="https://cultofshiv.wtf/tags/noradrenaline" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>noradrenaline</span></a> <a href="https://cultofshiv.wtf/tags/dopamine" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>dopamine</span></a> <a href="https://cultofshiv.wtf/tags/RightToChoose" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>RightToChoose</span></a> <a href="https://cultofshiv.wtf/tags/propranolol" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>propranolol</span></a> <a href="https://cultofshiv.wtf/tags/diazepam" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>diazepam</span></a> <a href="https://cultofshiv.wtf/tags/stimulants" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>stimulants</span></a> <a href="https://cultofshiv.wtf/tags/methylphenidate" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>methylphenidate</span></a></p>