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Hello all!

It seems to me that I am having a harder and harder time getting motivated to do anything.  I finally managed to clean my room and change the sheets on the bed after about 6 months (sheets, 3 mos.).  Only because my dad helped me (I live at home.  Don't know how I am ever going to make it on my own at this point.  I do plan on moving out by the end of next year.)

My pdoc says it is from depression.  I don't feel depressed.  I am not hopeless and crying all of the time.

It just that I don't have the actual get-up-and-go feeling at all.  My showers are less frequent.  I have stopped shaving my legs.  Anyway, I know this is all gross and everything, but I am so comfortable not doing anything at all.

This didn't just start with my dx.  Even when I was in high school I would come home, sit on the bean bag, watch tv and eat junk.  I was never really into anything.

When I was in college it was a little bit better.  I admit, having your own apt, you tend to do more.  But, again, I had a hard time getting off of the couch.  I think I was depressed then because I would come home and cry.

I would always be very cheerful at work and then come home depressed.  People had no idea.

I also have a hard time doing anything good for myself.  For as long as I remember, I have always made lists and charts of how I would like my day to go.

This included things like exercising, flossing my teeth, taking vitamins, etc.  I never kept up with any of it.

I had lists of things that I would like to learn about.  Hawaii, art, buddhism, etc.  Again, never followed through.  (I remember a point in college where I just couldn't learn anything anymore.  Nothing stuck in my head.  I could study the night before and retain the info, but beyond that, bye-bye.)

I tend to buy things such as tennis rackets, cameras, massage equipment and such with every desire to learn them and use them.  But I was only good at collecting them.  I don't get rid of anything because I still think I am going to learn them at some point.

I just feel like something is missing in my brain that doesn't allow me to do things.

My pdoc suggested Adderall, but I want more info before I do that because I have an addicted personality and don't want to go that route.

I was also diagnosed with narcolepsy because I was sleeping for 14 hours at time and was given Provigil.  I have tried it once and plan on giving it another chance.

It you read this all the way, I owe you a lot of thanks.

Oh, I was dx'd 2 1/2 yrs ago at the age of 32.  I am taking 900 litihium and 20 lexapro (which didn't help with an increase).

Thanks again for listening!

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First, you don't have to feel depressed in order to be depressed.  Feeling depressed or weepy or whatever that word means to you is only one, maybe two, of the official diagnostic criteria for depression in the DSM-IV.  (I realize much of the world doesn't use the DSM, but whether you're evaluated under DSM or WHO criteria, the results are pretty close.)  Right now, depression is this enormous blanket term used for a host of problems which appear to be related (in part) because they respond to certain treatments.  There are different kinds and experiences of depression.  Your doctor is right:  what you're describing could be one of them. 

On the other hand, you might be experiencing a different kind of slowdown.  Could the narcolepsy be having a general sluggish effect?  Is your sleep typically unrestful?  Has your thyroid function been tested?  Could you perhaps have suffered from a form of ADD over your life?  According to Amen's proposed model, low motivation can be a major part of certain kinds of attention deficit disorder.  Maybe you are suffering from a nutritional deficit.  There are many possible explanations, including depression. 

I don't know the exact nature of your pathological lack of will.  I don't know if you become engrossed in nothing, or if you become overwhelmed by all the possibilities of action, or if you're simply numb, or tired, or something else entirely.  I don't know if you're always trying to slow down and stop, or if you're okay and eager to do anything until you rest for a moment, at which point inertia kills your sense of purpose.  I just don't know.  But there are many avenues of explanation which can be investigated and exhausted, and an equal number of treatments. 

Adderall might work.  It's widely used for treatment of ADD in adults, and has done rather well in small studies treating comorbid ADD/bipolar patients who were also on adequate mood stabilizing medication.  I think Cerberus has been put on Adderall in addition to his antidepressants to help give him a little more kick, though his diagnosis is MDD, not ADD.  But yes, you are right to want to vet the medication thoroughly before taking it, given your circumstances. 

Feel free to poke around the boards you think might be most useful, perhaps including the CNS stimulant board in your rounds.  If something in the ADD hypothesis sounds promising, look around the ADD board, too.  We love questions.  And you can always ask more detailed question about other ideas you've come up with, too.

Edited to "dlamn the otypos."

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gettin' there:

You sure described what a large part of depression is for me. But, as lmnop says, what you described could be from many other things too.

I had been on Effexor for many years. For a couple years after Effexor pooped out for me (but I was still taking it), I used Adderall as well. It helped. The drawback was that I developed tolerance very easily with it. So, unless I kept upping it and upping it (which of course was not a good idea), it too stopped working for me. At the time, I was considered to have severe refractory, atypical MDD.

I've recently been dx'd as BPII, I believe finally correctly dx'd. Lamictal is working very well for me.

I don't know if any of this helps to tell you. Bottom line is I agree with lmnop; make sure you are getting a complete, thorough workup for what this may be, including thyroid, et al.

Good luck! Please keep us posted, okay?

revlow

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Heya gettin' there,

I don't have much to add to what lmnop and revlow had to say.

I will say that this sounds a lot like my depressions, except that I was always angry as hell to go with them.

You definitely need a good history and physical and basic bloods, like lmnop said.

I would also consider meds crapping out on you.

Or even med effects.  Long-term use of some meds can kill motivation, and I'd go look up which ones, but I'm supposed to be on vacation.  ;)

Good luck.

--ncc--

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gettin' there:

Well, I personally think it could be the Lithium. I say that because I take 1350mg of Lithium and, though it's helped me a great deal, I, too, have problems with motivation. But, I'm not depressed. So, I understand how they can be separate issues.

Let us know how the Provigil works. It's helped me a bit with both wakefulness and depression. But make sure you try enough (with your Dr.'s approval of course). Some people only try 100-200mg. That did nothing for me but 400mg did.

- Kiki

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