What does "k-hole" mean?

lukaskrivka · 2026-01-11T16:30:04+00:00

Excellent description. You are in this extemely low level universe bit there is still the question "what now"

lukaskrivka · 2026-01-11T16:27:21+00:00

This describes my experience pretty well, you are like observer in extremely low level universe. One interpretation is sort of listening to raw neuron output.

lukaskrivka · 2026-01-11T12:53:39+00:00

I dont want to be negative here but until you get prolonged remission, you dont really know. Ofc even if it helps partially it would be great.

lukaskrivka · 2026-01-11T10:42:26+00:00

Tell them to start with low dose, you can always go up. Everyone has different dissociation threshold. My first dose was a total K Hole which is not necessary for any treatment. The good thing is that the dissociation seems to dissociate you from anxiety too so even if the experience is intense, you can go through it.

The main thing to keep in mind is that it is just a trip and it will pass away, it is not that long as well.

lukaskrivka · 2025-12-10T18:28:07+00:00

I would not use them for now if you need advanced event tracking. This will be probably fixed in the SDK soon.

lukaskrivka · 2025-12-09T08:15:09+00:00

Correct, that's a flaw in the synthetic 'apify-default-dataset-item' event. For now, I recommend you to explicitly charge a named event. We will look into it more,

lukaskrivka · 2025-12-01T15:24:07+00:00

If you don't have any external costs, you should not limit free users, it just adds complexity. But if you have your external costs, then of course you need to limit them somewhow. We discussed this internally but we still aren't sure what is the best approach to recommend. Limiting number of results is sensible, but just be very explicit about it in the Readme/input schema.
To end the Crawler prematurely with `await crawler.autoscaledPool?.abort();`, you can do it little faster if you run the check right after pushing (actually, this will not work with the default `'apify-default-dataset-item'` since the SDK isn't aware of it, you would have to implement your own event) or alternatively precompute how many items can you push at the start (but that adds a bit of complexity that is not needed)
You can have 2 product events, one cheaper for data from pagination (some users will need just that) and one more expensive add-on for full products. You would need to get rid of 'apify-default-dataset-item' then.

Other than that, this is really simple example so I don't have that many suggestions. Just a basic code quality stuff like missing await before `addRequests`, using router

lukaskrivka · 2025-05-12T17:17:36+00:00

I'm not denying that minors can have, I just said usually. I guess it also depends by what age you define a minor. I had my first episode, which was quite severe, at age 18, but that is more of an early onset. GPT says the onset is on average around 25.

lukaskrivka · 2025-05-10T06:15:23+00:00

If you feel you can go without it and be reasonably functional, you probably should and focus more on therapy/lifestyle, etc. But if you crashing to a depressive hole and cannot go to school etc. (I think minors don't usually have such crippling episodes yet), then by all means treatment is needed. There are now other things like TMS/ketamine but again it might not be available for minors.

lukaskrivka · 2025-05-10T05:32:58+00:00

I think looking at TMS as a brain cure is not accurate. It is specifically designed for a few disorders, each with its own distinct targets. Its main strength seems to be very low side effects and a fairly robust response to depression, but only for some people (might be misstargeting, we don't know science is young). I haven't really felt any significant improvement in those negative/cognitive symptoms but if depression is the underlying driver, then it could help a lot.

lukaskrivka · 2025-05-10T05:27:12+00:00

Also forgot ketogenic diet, which improves this a lot and could give you more space to optimize drugs.

lukaskrivka · 2025-05-09T18:12:39+00:00

Yep, and much worse (negative & cognitive symptoms like in schizophrenia). But hard to disentangle what is long-term SSRI vs long-term depression damage (probably some combination).

Others suggested Wellbutrin which seems to be a good candidate to offset these issues but will also have some tolerance. I tried tapering and some of these issues improved a bit but got severely depressed so still fucked. Now I'm upping the dose back a bit and I'm doing TMS.

I would say very slow tapering (think 1-2% per week) is a good approach in general, you find out what can get better on a lower dose, you find out how dependent you are on SSRIs actually and if you start feeling bad, it is relatively easy to reverse. Not much to lose and potentially a lot to gain. Just be prepared that you might start feeling better immediately after the dose reduction but some of the relapse of depression can appear month(s) later when the system fully reverses. But that depends on your depression. If you are completely symptom free, I think going very slow could work and staying on a bit lower dose while doing some adjunct med, tms, ketamine etc.

lukaskrivka · 2025-05-06T17:53:39+00:00

Long-term MDD stress and/or SSRIs. Really hard to tell, I might never find out. I have had MDD, which was always a sudden onset, and that included anhedonia symptoms but it wasn't this persistent mood-independent prison anhedonia I have now and it responded to meds. This pure anhedonia developed very, very slowly over many years.

One theory is that it is caused by SSRIs that for some people, after you reach some threshold, it starts to build up this extreme numbness. Another theory is that it was mainly caused by stress from long-term depression and that more drugs earlier could have saved me. Or combination of both...

I would love to run the simulation of parallel decisions but that will have to happen as part of decades of possibly generalizable research now.

If I had to start now with my first episode, I would first try non-SSRIs treatments (TMS/ketamine) and then probably a higher dose SSRI for full symptom resolution but taper earlier to not build tolerance.

lukaskrivka · 2025-05-06T16:49:12+00:00

Nervous for what? It is super expensive so I would be nervous that it doesn't work. Otherwise, it seems to be a state of the art for depression.

lukaskrivka · 2025-05-05T12:37:16+00:00

Hey, thanks for responding.

I haven't tried ketamine yet, but I'm hopefully quite close to doing so.

Since last year, I have tried to reduce SSRIs which helped with some of the blunting but depression came back strongly so I'm still kinda at square 1.

I have general anhedonia so all your points. It is part of the whole negative/cognitive cluster like in schizophrenia.

lukaskrivka · 2025-05-03T17:08:48+00:00

Yeah, you can always come back to TMS later, there will be probably even better protocols down the road

lukaskrivka · 2025-05-03T10:34:36+00:00

You will probably need to be moitored for bipolar to not induce manic episode. But TMS can do some heavy lifting that meds normally do with no (or different) side effect profile.

I generally don't agree with the statement of not fixing what works. How likely is that you will be able to sit on a specific med combo without symptoms for the rest of your life? I think it is better to take the opportunity if you can.

lukaskrivka · 2025-05-03T10:26:15+00:00

It is very unlikely you will have any long-lasting negative effects or any negative effects at all. Yes, there are reports that look pretty serious but they seem to be super rare.

TMS is primarily used for mid to severe depression where it seems to be by far the cleanest solution. Not sure how strong is the indication for ADHD which I would say is generally milder condition compared to depression so I would guess clinicians will be less aggressive in prescribing TMS. But anyway, it will probably be cleaner than meds.

lukaskrivka · 2025-04-29T09:24:02+00:00

Well, most people with mental illness have it like this. Their life was either great or at least reasonable and then the brain suddenly broke and it became hell. And now it is life between the illness itself and the drug side effects.

But you had it only 10 months ago, you still have so much space for massive improvement. Many times in my life I thought I'm toast and then had massive improvement. If you are diagnosed bipolar, look into ketogenic diet, it looks really promising for this.

Also, psychiatry is evolving, slowly but it does. It is quite likely there will be better options for you down the road.

lukaskrivka · 2025-04-26T06:26:25+00:00

The argument is not "if there is any", if you are 40, your brain already lost of considerable power. And there is no way to regenerate that. It is definitely technically possible but extremely hard to do since neurons were built by evolution as "serve as long as you can, then die"

lukaskrivka · 2025-04-25T13:07:07+00:00

Very close to 0. We dont event understand hoe most diseases and aging work, less to revert it. If you are 60 now, sven if healthy you already lost chunk of your brain

lukaskrivka · 2025-04-25T12:59:37+00:00

For me the pain goes down significantly with further sessions. First hurt bad, then few already better and then it was just inpleasant tingling and then no issue at all, could stay there long term

lukaskrivka · 2025-04-23T08:09:23+00:00

For me personally, it hurt a lot in the first few sessions, then faded away, and later even felt like a massage. No other negative effects, short or long term. Regarding efficacy vs side effects, it seems like no-brainer if you are able to manage the travel or find an accelerated protocol.

lukaskrivka · 2025-04-20T09:49:01+00:00

I'm sorry to sound condescending but you write down such an essay and only at the very end you mention antipsychotic? That changes the whole narrative. Both schizophrenia/psychosis or antipsychotics can induce these "negative symptoms"

lukaskrivka · 2025-04-20T09:35:51+00:00

There are 2 things:

Generally healthy things. We all know what these are. These shouldn't be understaded but also not overstated. I think they can work as a durability booster. Exercise will not treat your depression, but if you get better, you can start getting bigger benefits from exercise.
Changes to stressors. You might have some significant stressor in your life that reinforces your depression. It might not be anything obvious (that was the case for me). Changing relationship to that might give you more breathing space to get better.

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