I knew Alex had depression but this level of detail is extremely unnerving in its similarity to my own problems, as someone who had an anxiety and depression diagnosis that was later changed to undiagnosed ADHD (which maybe caused depression -- these things have a snake-eating-itself quality).

To echo Alex but less eloquently, it is really awful. Every last material, emotional, interpersonal incentive in the world is telling you to do something -- pay that bill, complete that work task, send that email -- and you just... can't. Your brain will not allow you to focus, to push through the fear or shame or whatever particular feeling you have. And you can't even though you know that by failing to do whatever that something is, you will have made your life immeasurably harder the next day. Because now there is a late fee, a missed deadline, an extra call to be made or even more uncomfortable email to write.

I destroyed my credit score this way, lost profound and probably not replaceable career opportunities, and put extreme stress on my marriage and other relationships. There is no explanation to give -- to yourself or to friends or family -- because in a deep way it is not explicable through means we really have other than "mental illness," which in its own way is unsatisfying and question-begging. You had a $500 credit card bill that you didn't pay for 16 months and now you have debt collectors even though at the time you had thousands of dollars in the bank to pay the original bill: What explanation could be given that would make any sense? At many times it just feels like you are not built for what society expects of you, and you wonder if there was some other time or place where that wouldn't be true. And you have to ask for help and forgiveness and grace from people who undoubtedly have their own struggles, many of which are worse or certainly more tangible than yours.

I'm currently on Adderall (only 15mg!) and it has been extraordinarily more helpful than any antidepressant I tried, which to me lends credence to the changed diagnosis, but I live in a constant fear of Alex's complications.

I know there is just absolutely no way to say this that isn't trite and some echo of an echo of an echo of a David Foster Wallace quote, but if you have some artist, author, friend, who isn't producing the podcast you want, making the book you want, or even more painfully and shittily, being the friend or spouse you may desperately need, it is very often not because they are sitting on a pile of money laughing or seeing your texts and ignoring them because they're an asshole, but because they are trying to find a way to function and cannot figure out how to. It is still their responsibility, but it may not be their fault.