It's hard and not fair.

I want to tell you that I have a job that I love but I don't want to suggest that everyone can manage traditional employment and I have also been on leave since June and just recently started a reduced schedule so...

So I don't know what kind of peace acceptance would grant me, knowing that I will never have the life I want and I'm just going to be flipping channels until I die.

It's not acceptance if you are not at peace with what you have.

I don't have any advice on how to get there nor am I trying to suggest that people should just suck it up and be grateful when we are denied full participation and basic needs because of our differences.

I guess I just want to express empathy. I've been totally hopeless because of the mismatch between my brain and the world, but I've managed to find a bit of acceptance too.

I saw you mentioned trying meds and having an issue just doing the same thing you'd normally do but for longer as well. I recently started meds and have noticed the same thing, and especially if you were undiagnosed for a long time I think this can be a big problem. The meds help a lot, but they aren't a cure-all. They really require discipline as well, especially for people who are older when they start them. You went for possibly decades with a chemical deficiency in your brain. Your brain built up a whole set of habits and neural pathways dedicated to hacking this deficiency, and gaining dopamine any way it can. Now the meds can help regulate that dopamine, but the ingrained habits are still the path of least resistance. The meds can't overcome that on their own. Your brain has an immense amount of experience feeling like 'being productive' gives no dopamine, no reward. The meds make it so that being productive can feel rewarding, but all the little hacks that you picked up along the way to get that dopamine fix also still feel rewarding with the meds, sometimes even moreso than before. So you need to overcome that inertia and train your brain to realize that no, actually laundry isn't a torturous experience that must be avoided at all costs anymore. Now with the meds it actually can feel like you've accomplished something. But in order to do that you need to build those habits, and then initiation will get easier and easier. If you start the meds without a routine, they can easily just reinforce the bad habits that have been built up over years of your brain being wired wrong which is something a lot of doctors don't talk about/realize with older patients.

I've had negative motivation for many things, I have not been able to get around some of them but, for the ones I have been able to deal with, my most effective driver has been spite.

The best example I have off the top of my head is I had some pretty weird back pain / sciatic a nerve impingement symptoms. I also have hypermobile EDS. I went to a physical therapist to see if they could do anything and I researched the specific one that I wanted to go see because he was supposed to be really Hands-On and might help like with massage and scraping and not just send me home with exercises. He did the basic intake form with me and then punted me off to some less qualified less licensed assistant type person who did not listen to my complaints or pay attention to my chart at all. She had me do a couple movements and decided that my ass was weak. Those are the literal words she said. "Your ass is weak, that's the problem." My ass was not weak because I didn't have any muscle, my hip was not seated properly in the ball/socket joint at the time and therefore I had significant weakness in one leg. I told her that and that I knew that wasn't the problem, she refused to listen. She sent me home with a handful of exercises that I knew were not going to address the problem so I did the research for what would actually help for myself and did those exercises very specifically and not the ones she gave me out of spite. It worked of course and I went back the next session, in between I had also been able to put my hip back, and did all the things she asked me to very easily and she was just flabbergasted at how I could possibly have made so much progress. I told her "I said I had EDS and that my hip was out, that's why my leg didn't have much strength." This bitch had the audacity to say "you have h-EDS? I had no idea! I should have given you completely different exercises!". I of course never went back to that physical therapist's office but I continued to use spite to "prove this bitch wrong" and it was soooo motivating. That has been the best and longest run of dedicated strength training and cardio exercise I have ever started, all because the beginning motivation was "fuck you bitch! I know what's right and I'm not going to be gaslit into listening to your stupid fucking face when you won't listen to me and don't know what the fuck is going on."

I found that creating that sensation of "fuck you! I'm going to do the thing I know is right just to make you fucking angry and show you how wrong you fucking are" is the best way for me to turn negative motivation into positive motivation.

It's almost like you knowing what you should be doing is one polarity of a magnet and you knowimg you don't want to do it is the other polarity and they cancel each other out and you're left stationary, but somehow adding spite into the mix kind of flips the polarity of one or the other and gets you moving. I have even been able to do things out of spite of my own brain. Like, the negative self-talk voice in the back of my head is being such a cunt and I'm just like "you know what Steve!? (I named the negative voice in my head Steve) I'm going to get up and do the thing just to prove how fucking wrong you are because you are being such a stupid bitch right now!" I try not to think about it too hard because it works for me and I don't want to examine why and have it stop working so... do with that what you will.

pathological demand avoidance Pervasive Drive for Autonomy

I think the unfortunate reality is that there is no magic bullet solution, no matter how much we wish there might be. All the hacks and medication in the world aren't going to solve the societal problems that cause us the most distress. Vyvanse might help me fold my laundry, but it's not going to change that rent is due on the first and if I'm late to work again I'm going to get fired

Depression really is its own bag. I'm not in medicine, but frankly I think it's more of a symptom than a disease of its own. It's comorbid with ADHD, autism, PTSD, compulsive disorders, anxiety, gender dysphoria, poor diet, and even just living under the constant pressures of the modern world. We have medications to manage the symptoms, but a lot of the time they're a crapshoot and without treating the underlying cause you really aren't likely to show improvement.

I also think treating depression is prone to a cart/horse problem where people confuse cause and effect. Anybody who has suffered from depression probably knows and was infuriated by the advice that if you just get out of bed and exercise then you won't be depressed. Then one day you get out of bed and exercise and don't feel so depressed. The outside observer sees the exercise and concludes that it cured your depression. They don't see the countless hours of therapy, the constant reframing of problems, the restructuring of your life to accommodate self care, the medications that got you to that point, etc

It's beyond naive to think that some pushups and going for a walk cures depression, but having experienced it for yourself you might even conclude that was the case. But I posit that you were able to get some exercise only because you were less depressed than you were before, and something else had to happen to get you to that point. It's tempting to look at the data that shows the correlation between people who exercise and people who are depressed and conclude that a healthy lifestyle fixes depression: but another interpretation is that the people who are depressed can't lead a healthy lifestyle.

Personally I think that's where a lot of the well-meaning advice is helpful but also totally misses the mark. People will say (or insidiously get paid to say) that something helped them and it brought them out of the funk, but it was probably a myriad of things that working together helped elevate them to a point they could take back some control over their life. There's a million billion articles about whatever self care fad is a miracle cure, but if it does indeed help then it's just a piece of the puzzle.

Pessimism aside, self care is pretty important. But it's also personal, only you know what truly makes you feel better. My experience is that if you do anything specifically to make yourself feel better without forcing yourself, then it probably does help you feel better. We're tempted to look at the action (taking a bath, reading a book, putting your phone away), but it's really the intention that helps (I want to feel better, so I'm going to do something to feel better). It's a mental problem with a mental solution, and while that solution might be mercurial or difficult to take hold of, it's the best tool I've got.

Anyway, rant aside: I also hate that the solution to being depressed is to not be depressed. It's doubly extra super frustrating that my best advice also boils down to "stop being depressed," although I hope I've framed it in a way that shows that it's not as simple a solution as it sounds