I used C# and XNA. Admittedly XNA helps with basic stuff like drawing sprites and such, but yeah, you still need to get down and dirty with code. It's definitely not like using Gamemaker or some game creation tool.
The hard part that no one ever sees is that I had to create a number of programs... level editor, character editor, dialogue editor, etc. And being visually minded I sort of wanted to make all those look nice too. So yeah, now that I've created tools development should go much faster for future projects.
I guess I'm just good at reusing my code. Creating a particle was very difficult. Tweaking that particle for a hundred different uses was much easier and very fun.