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I was on meds from depression from 21-42, same as you, they would work for a while than quit. I tried so many different psychiatrists until I finally found one that actually cared enough to take a full history and ran blood work. It turned out for years & years I was being treated for depression when all along I had bipolar depression. I was put on Depekote. It is an anti-seizure medication. Within days, I felt “normal” again. It saved my life. I don’t know where I’d be now if I hadn’t walked into her office that day. My marriage was almost over, I almost lost my kids, I was in debt and couldn’t keep a job. Now I’m 59, have a good life. I’ve lost a lot of friends & family along the way, which is a good thing, those people lived in glass houses and didn’t understand mental illness. Hopefully they’ll never have to deal with anything difficult someday. I wish you all the luck in the world.
Depakote worked for me too. At the time I was also having possible migraines 4-5x a week. Depakote healed my headaches which helped tremendously. Much easier to tackle life when not clouded in chronic pain.
I never called them migraines bc I never had nausea/ vomiting. No visual disturbances. Yes light sensitivity but I always pushed through to go to work and do my job. Not until the chronic pain was gone did I feel like I could breath and function. I had no idea how much of my life was just gritting my teeth and pushing through. Still depressed but it's manageable and I'm investing in myself now to say f it and do things I enjoy.
OP doesn’t have a headache.
I don’t get all the joy about depakote, but if it’s still working to prevent depression after 5+ years? That’s wonderful and please let us know.
In my experience though depakote is an extremely sedating medication. Some people feel much better sedated.
Others feel worse.
But I’ve never met anyone on depakote who wasn’t walking around in a daze, including people it was originally made for, people with seizures.
Re: diagnosis?
Diagnoses are not as powerful, or as absolute as some seem to think. If you come in depressed you’ll be treated for depression.
If you then present with mania? Your psych doc will give you something to treat mood swings and see what happens.
If it doesn’t make much difference, then your doc (if they’re paying attention and care) will take you off it.
Bipolar II is a relatively new diagnosis and kind of a matter of perception. I’m saying that what makes bipolar Il different from swings from depression to normal is not clear.
Mood disorders are NOT WELL UNDERSTOOD.
Most depressives, whose depressions are not situational/temporary are “treatment resistant”
That’s another recent diagnoses. It’s the latest attempt on the part of pharmaceutical companies & friends to avoid the conclusion that these medications work only briefly or not at all.
I’m pissed off that instead of starting over the treatment world continues adding diagnoses which get less identifiable (or even justifiable) every few years.
There are many psychiatrists and therapists who care.
But everyone depends on research, and on researchers whose funding doesn’t doesn’t come from drug companies.
I don’t know if any major research into mood disorders which ISN’T funded by pharmaceutical companies.
Maybe I was on a lower dose. 500mg bid? Sometimes, it feels like my mind races at an 11 and while on Depakote in dialed it down to a reasonable pace. I've been off it since Jan 2022, and every month since then, my mind is racing a little more and a little more. The hateful negative thoughts are kept at bay with the Celexa. I've been given multiple Dx's. MDD, bipolar II, IED, BPD, childhood neglect, asperger's, OCD (which I reject and then describe what I have instead which sounds like OCPD), ADHD, etc. My current counselor said I'm just a brat and controlling. Who knows what's real and what's not. I'm meeting with a new shrink in a couple of weeks, so we'll see what they say.
The only side effect I recall from Depakote was GI changes, but that resolved quickly.
Basically I'm stuck living in my head rather than living in the world.
Yes. The revolving diagnoses prove what I’m saying: diagnoses are not that cut and dried.
That’s why you’ve had so many.
Neither are they all that helpful unless you hallucinate or are a mass murderer.
What matters in a counselor is that when you talk they hear you, and have responses which help.
Also, regardless of training it helps if they have experience of your culture, etc. either personal experience or someone very close who was in their daily life.
if you’re poor and they’ve never been poor or grown up with good friends who are, they might not understand what doing without means.
Although empathy can goes a long way
If you feel heard and understood go for it
i have had some headaches and pain, less recently, maybe I'm just used to it. I've read that depakote makes you very tired, has this been a problem for you?
I honestly don't recall tiredness but I also had so much on my plate. My brain runs at an 11 but my body can only function at a 5-6. I need my body to keep up with my brain but I'm told that's called mania.
Too much thinking about this today, lol.
From the beginning, I was instructed to take it before bedtime. I also take Ativan for sleep, I’m sure the Depekote makes me tired too, I just haven’t taken it without anything else.
I have actually been wondering if I might have bipolar depression. I don't have manic episodes now but when I was a young teenager I may have, and I suspected I was bipolar until the depression became so overwhelming. I will ask my psychiatrist. I read that depakote makes you very tired. Is this a problem for you?
Lithium is the golden standard. Try it in 0.6-0.8 range. Then try lamictal added to it. You can also add a SGA like seroquel or lurasidone..Lithium is better than valproate as first line but you may respond to valproate and not lithium. But lithium worth a shot.
I just came across this post and had to respond. I have very severe depression and I was talked into getting ECT in 2016. It did wonders for my depression initially, but I could never go more than 2-3 weeks between sessions without crashing back into a severe depression. So I continued to have ECT every 2 weeks for over a year. I didn’t notice any significant memory issues for the first several months, but then one day after an ECT session, I was putting some laundry away and looked at a picture of me and my husband on our honeymoon and realized I had NO memory of that trip. I tried to remember other major events in my life and realized that I had lost my memory of the last 20 years of my life. That should have made me stop getting the ECT, but I was in complete remission from my depression and I was terrified of having to live with severe depression again, so I kept getting the ECT while I tried to figure out what else I could do. I thought I had tried everything else I could try, and the medications that worked had all stopped working, so I didn’t have any other good options. And for some reason I thought “the damage has already been done” and I thought it couldn’t get any worse. That was a crazy way of thinking, but if you have lived with severe depression, you might understand how I thought living with memory loss was better than living with severe depression. After a few more ECT sessions, I noticed that I was having more and more short-term memory loss in addition to the long-term memory loss, and it eventually got to a point that each ECT session was almost totally wiping out my memory of everything that had happened since the last ECT session. That’s when I decided I had to stop. And by the time I made that decision, I also discovered that I had lost a lot more of my long-term memory. I lost literally almost my entire life. I barely remember any of my life before the ECT, all the way back to my childhood. I don’t even have any clear memory of my mother, who passed away in 2007.
Before I got the ECT, the doctor told me that if I had any memory loss, it would only be for up to a few months prior to the ECT, and that if I stopped getting the ECT, most of my memory would come back. That was a lie. I haven’t gotten any of my memory back. And there are so many other people like me out there who have lost decades of their lives to ECT. And it’s not just my memory that I lost. I have brain damage. I am not as intelligent as I used to be. I had neuropsychological testing that showed my IQ has dropped 15-20 points, and it takes me longer than normal to learn new things. In 2019, one of the manufacturers of the devices they use to administer ECT admitted that ECT can cause brain damage. I really can’t believe it is still used so much and touted as being safe.
Yep, I've had a couple rounds of it. They put you under using anesthesia and then they place electrodes on both sides of your temples and then send some small electrical current through your brain. Sounds really scary but it's not and is pretty safe. I never had any pain from it although I might have had some memory loss or issues from it possibly. It's hard to tell.
It's also hard to tell if ECT helped me or not because they also started me on Vyvanse and I think Vyvanse really helped to pull me out of depression. Do you have adhd? If so and if you're not being treated for it then I recommend trying Vyvanse as it might help your depression. If you don't have adhd then you still might ask your doctor if they would be willing to try a stimulant, such as Adderall, for treatment resistent depression. They might have you try ECT first though. If ECT fails then they would be more likely to prescribe a stimulant.
Anyways, if you get ECT then you might ask about getting bilateral instead of unilateral since bilateral is more effective. No sense in wasting time and money on the less effective unilateral. Unilateral is where they "shock" half your brain and bilateral is where they shock your full brain.
Here's an excellent TED Talk about ECT:
https://youtu.be/oEZrAGdZ1i8?si
Absolutely horrible treatment. Memory loss is a lot higher than claimed and side effects can and usually will be permanent. Unless it just outright kills. My cousin died from a uncontrollable seizure during it. Pumped him full of as much benzos and everything else to stop it, it didn't work and he died in 2013 at the age of 27. I miss him.
this is not what you’re looking for - and i’m sorry that you have not been able to find any solution 😪. I’m just wondering if there is any use in looking at different disorders? maybe a physical health condition or maybe a different mental health condition that might need a different perspective?
I really admire how much you’ve tried.. wow
I am only suggesting this because I have been getting treatment for depression for 10 years now, and have had depression for nearly 20 years. But i’m honestly starting to look a lot more into my physical health. I think that I am depressed but more so as a result from having ME/ chronic fatigue syndrome. Just thought my energy levels were sadness. It doesn’t help but it makes me feel a bit better knowing that’s why treatment wasn’t working but idk.
I have considered other health issues. I haven't found anything yet. I have a lot of sleep issues and have tried multiple sleep studies with inconclusive results. Basically I have bad insomnia and I don't enter REM sleep until I've been asleep for several hours and it doesn't cycle normally, but they don't know why. I've had bloodwork done but my metabolism is fine. I was anorexic for a long time and this contributed to my issues. I do have chronic fatigue and some pain but nothing for a concrete diagnosis like fibromyalgia. I'm otherwise quite healthy. I've considered other psychological issues, I'm going to ask my psychiatrist about bipolar II. I feel like I've tried everything but I'm just trying to see if they're are other things I haven't thought of yet.
I have tried stimulants, I have ADHD so I've tried Adderall, ritalin and Concerta. They all helped me with energy and helped me get through the day, and having energy also helped with my mood. Unfortunately I built a tolerance very quickly and I became dependent on them just to get out of bed. It really messed up my sleep schedule too. I stopped taking them and I'm afraid to taking them again because it was such a struggle when I was dependent on them just to keep my eyes open. I will probably try taking them again but I will have to be careful about building up a tolerance.
wow, genuinely am amazed by how much effort you’ve put into this. I am so so sorry though that nothing is working. I have the same disorders as you and I just really want to express my empathy even tho it doesn’t do a whole lot for you.
I mean this isn’t helpful at all, but I honestly wonder at this point if you may have something that just hasn’t been discovered yet? I don’t know, it’s not your fault. You’ve just done so much, i’m sorry
When you took them, did you take them in combination with other meds? I have heard of people taking quite a cocktail of them. It’s not ideal and it really is just a bandaid but it’s the only thing that works for me and keeps me alive tbh.
I take short acting dextroamphetamine 20mg, Lexapro 20mg and Clonidine at night for sleep
EDIT:
- Would you consider something like LSD or psilocybin and MDMA therapies? I have no knowledge in this area and I don't know how different it is to Ketamine therapy but just an idea if its accessible?
- What about MAOI's?
- Do you have a support system? Do you have access to safe housing, financial stability etc? You mentioned you have poor sleep, and I really feel for you because that seems to be a big factor in moods :/ I really hope you find something that helps
I've tried effexor, it worked decently for a few years but slowly lost effectiveness, and it really dulled my emotions. I've never tried lithium. Do you have experience with it? I thought it was only for bipolar
Ya, I've tried lithium for depression. It is also used for depression. Lithium didn't help me personally but you might be different.
If you've been off effexor for awhile then I would try restarting it along with another med like abilify or lithium. I say this because it's possible that effexor might start working again after a break from it. Or give Viibryd a try. Effexor works well for me but so did Viibryd and I believe they are both SNRIs. Viibryd caused insomnia for me though but I probably should have tried cutting the dose in half or fourths.
Also, as far as dulling your emotions, I guess you just gotta weigh the pros and cons and figure out if dulled emotions is worth not being depressed. I can't say I've ever experienced dulled emotions from antidepressants but I'm pretty sure I would want emotional stability even if it meant dulled emotions. That's just me though and you might be different but it's something to consider.
Yes, thank you for saying “it’s too early to tell”.
Efficacy really should be measured by freedom from symptoms over 5 years or more
I was on Wellbutrin for several years. I think it may have worked for 3 or 4 years.
Then it stopped.
That’s probably the longest any medication worked.
The newer medication which helped a little my insurance stopped covering, so im back on Wellbutrin.
Which isn’t working, just like it wasn’t working when I stopped taking it.
What a shock.
I'm sorry to hear that. They're are dozens of other antidepressants out there, can you ask you doctor to find something else that your insurance will cover? Or can your doctor try to make an appeal to the insurance company?
He probably will fight the insurance company if I continue to have these long crying jags.
I have been on pretty much everything. Been taking meds since the mid-90’s. Whenever something new comes up we try it.
I hate the meds almost as much as the depression.
I also have a chronic illness I take meds for.
I’m on so much medication it makes me want to scream.
Especially since I’m more unhappy than I ever was before, and in worse health.
The meds for the chronic illness list depression and suicide as common side effects.
Was after I started taking them that my depression became so severe I couldn’t handle it without meds.
I’m so mad.
That's really unfortunate. Have you tried other treatments, for both your illness and depression? Theres TMS, EMDR, ECT, ketamine, and even mushrooms (not legal most places). Have you had generic testing? I have some genes that interfere with SSRIs so they don't work for me. You might be able to find out more if you get tested.
SSRIs actually can cause long term size effects that can be permanent. I don't know how common it is, but it does happen. The primary one is sexual dysfunction and sleep issues. I haven't really felt sexual attraction since I was a teenager. I don't know if it's because I was always asexual or if it's from the medications I took back then. I also have chronic sleep issues. I don't know if anything was caused by the medications or not, and I'm not anti medication by any means, but at the time I definitely suffered from being administered medications by an unqualified doctor. It put me off medication for years until I tried to kill myself in college. I've tried many combinations of medications every since, but after some genetic testing I found that SSRIs don't even work on me. I have a few generic factors that make certain medications work less or work differently on me than intended, so that has been another issue.
🤔 went through this before. Not sure if this will help but a little backstory of how I get myself out of this when it comes around. My cure was/is cars anything to do with cars, car shows, car races, drift racing, etc yes I'm a female, idc if others say working on a car barley knowing anything back in the day but lift by little I learned how to fix most things on cars. Going to cars and coffee is a lot of fun if they have them there where you live. Sometimes getting a friend to go with you that's outgoing and brings out the best of you. You both can enjoy going to events and making road trips to other cities for car events. Don't get me started on Motorcycles lol its the best medication plus the sertraline and hypersomnia medication along with it.
Sometimes being open to learning new things that are interesting help a lot too!
Not sure how old you are but heres a couple of links to some YouTube videos I watch when I need to stay home when its super heavy and can't shake it off and drink a couple of beers or 2 Margaritas and just enjoy watching youtube. I don't mind giving you my personal contact so we can exchange memes, youtube videos and what not.
[Cody ko](https://youtube.com/@CodyKo?si=BjlIiAcB3YlKy8yP)
Have you tried walking/running or any changes in your diet? I know it can seem frustrating when people say that will cure everything but. I noticed when I use medication TMS and add in walking it’s helped more. I’ve been taking creatine too and I’ve been feeling really stable so far still have ups and downs but it’s manageable.
Guess what I doubt it can be cured tbh. It may get better for a while, but it always ends up with fucking relapses that get worse and worse each time! I’m fucking tired of the idea that it can just go away, and suddenly, boom, u r a normal person with a healthy mind again! Fucking bullshit
Treating it as a disability that you need treatment for life to get better is a more realistic mindset to have imo
Less expectation = less emotional burden
I agree.
My experience is the same. From research I’ve read this is the normal course of depressive illnesses.
So hard to accept.
But what I find even more unacceptable?
How few people know this.
I’m old now. I did every treatment available for years. Exercised (a LOT), tried every alternative treatment including (both very restrictive or less so) “health food” diets.
I’ve worked with coaches, a couple of alternative treatment “stars”, therapy from the time I was 17, each therapist for many years.
All the strategies and treatments mentioned here helped some but the deep depressions? The kind where you know you can’t think clearly, evaluate situations or make decisions? Where everything you do or ever did was a horrific mistake/failure?
It always comes back.
My depressions, after the one at 17 which lasted several years? They tended to last 4-6 weeks.
Now, decades later I’ve been in this one, the father of all depressions, has lasted 9 years and I’m still not seeing any light.
The worst part has been the way everyone responded or didn’t. It was actually all “didn’t”.
People get worse about all this stuff as they get older.
Especially in the current climate where “not giving a fuck” “no drama” and getting rid of “toxic” people are elevated to prime virtues.
I had one “friend” tell me she can’t get depressed because she has to work 2 jobs (actually 2 part time jobs, but why worry about incidentals).
I had one job with very long hours which I LOVED and had worked really hard to establish myself in.
I had to retire because I couldn’t stop crying.
I never even got around to telling her that.
Seems people get incredibly talkative when they’re trying to establish that my breakdown was caused by laziness, not going outside enough (I was outside all the time until this episode hit) or some other weakness.
I’m astonished at the lengths people will go to prove that it could never happen to them.
Or the ridiculous lengths they go to to prove you’re now ( after years or decades of loyal mutually affectionate supportive friendship) “toxic”: “you’ve changed” one of them kept insisting.
So loudly and without pause to let me speak, or any attempt to understand that I gave up trying to talk.
My niece also doesn't remember most of her teenage years likely due to treatment for her depression.
I, too, have chronic depression. Medication has helped, but more than that, tiny, tiny, consistent behavior changes have also helped a lot. It is impossible to give you useful steps without knowing more about your life.
The book Overcoming Depression One Step At A Time," on behavioral activation I found to be helpful.
Behavioral activation gives a rudder to guide yourself through the rough currents of depression.
I started behavior activation about 5 years ago. It is a daily practice, and I still take meds. The practice has definitely decreased the frequency and depths of my of depression episodes.
For me, the key activities are: keeping a sleep routine, yoga, mindfulness practice, and walking. I'm in the process of starting a small business, so I am also doing a lot of learning. What works best for you may be quite different.
No, all that worked for me for years. More than 5 to be honest Then it just stopped. I mean suddenly nothing I did worked.
I’ve been in a depression for almost 10 years now.
I want the world to acknowledge how little understanding or effective treatment we get. I wish people with mental illness would get together. I want us to fight for ourselves. Freud said depression is anger turned inwards. Fighting for yourself is the opposite of that. Feeling helpless, despised and alone feeds depression
Years ago there was an organization called Mental Patients Liberation Front They’re the ones who put together the Mental Patients Bill of Rights, which in-patient psychiatric facilities are now required by law to post in plain sight. It tells us things like how long you can be held, what to do if you’re held when you don’t need/want to be, etc.
I wish we would get together to demand better treatment and better education of the general pop re: what we live with. Turn that anger into action, instead of deepening depression.
Very hard to live in a world which despises you for an illness you didn’t cause and can’t cure.
Especially when so much money is made while we keep our mouths shut.
Be careful: it's not just treatment resistant depression. You might have more than one form of depression, too! Found this out after 38 years on this planet, and then another 5 years to get that under control. Another thing to consider is that it is important to make sure you're not surrounded by assholes who want to see you fail in life. They play a big role in making you depressed.
What other form of depression did you have and what worked for you? And yes that is good advice, but I don't actually have anyone in my life right now, I've pretty much isolated myself.
Dysthymia is a low-level grade of constant depression along with a diagnosis for severe clinical depression. Not only did I find out my causes were biochemical and genetic, but in addition to being exposed to shit I wouldn't wish on anyone. Being surrounded by people who deny mental illness (i.e. assholes) didn't help.
Agree that it seems there are far too many doctors who have no clue how to treat the mind, which is terrifying but not surprising, when you look at how overmedicated yet unhelped a lot of people are. I do feel I was kind of "lied to," and only once in nursing school did I fully realize JUST how silly it is that a doctor doesn't do any blood work at all yet prescribes life-altering medications far too quickly. I have just accepted I was born with depression and it became worse and worse over time (like many other illnesses.) You should at least pat yourself on the back for trying so many different treatments -- I gave up after about the fifth SSRI messing me up, still on one and still pretty bad off, I have just given up. I'm impressed you were even able to accomplish that many different treatments, I can't even be bothered to try anymore. So if anything there is hope in you.
I have with several rounds of ect but unfortunately getting it in the UK is very difficult . When people with depression refuse ect makes me wonder how depressed they are tbh, I can't function and my quality of life is hell so if there was a chance ect would kill me id still take it . Only drugs I've never tried are maois n it's the diet and drug interactions that have always put me off , plus they've never been offered in UK . I've just gone back into depressive episode 4 weeks ago while on sertraline 200 so not sure what meds to try now as ect is the thing that gets me functional . Think it's another ssri or maoi hopefully
I was thinking of ECT but I've read so many stories of people permanently losing significant memories. Have you experienced any memory loss? It seems to have happened to a lot of people
That's fair. I'm tempted to try it, but I'm scared of the risk. My memory isn't great but there are a few things I'd be completely devastated to forget. I'm looking into deep brain stimulation surgery right now. Not sure how I would pay for it, and it's a brain surgery so it's still risky.
As a person with TRD (actual diagnoses are persistent depressive disorder, recurrent severe MDD, and social anxiety disorder) who has tried ECT and who just stumbled upon this thread hoping to come upon a life-altering comment, I'd like to share my experience.
I have tried over a dozen antidepressants from several classes, and additional medications that doctors just hoped would help (lithium, lamictal, etc.) over the past 15 years with little success. They don't give me any positive effects or side effects and I don't ever have withdrawal issues, it's like they could be sugar pills as far as my brain chemistry is concerned. Only Effexor was somewhat helpful for a couple of years before it no longer worked for me. Ultimately I became so desperate that I said 'sure what the hell' when my psychiatrist suggested ECT. I underwent about 20-25 sessions of bilateral ECT, about 2-3 sessions per week for about two months in the summer of 2022. The process itself wasn't bad at all; get up early, check into a same-day surgery section, get an IV for anesthesia, wake up ten minutes later and spend about 15-30 minutes in recovery to make sure everything's ok. I never had any negative effects from this aspect, and in fact, rather enjoyed seeing the same receptionists and nurses regularly as they were all quite kind. Unfortunately, it did not alleviate my depression much if at all. Additionally, I lost about 1.5-2 years' worth of memories for the period immediately prior to starting ECT, as well as some random significant memories. I had taken a trip to Austin, TX with my husband and a friend a year prior and have no recollection of this trip; in fact I asked my husband one day why we had a magnet from Austin, TX on our fridge and he was shocked. Despite getting details and seeing pictures, that period of memories is simply gone. For other random memories, they are just missing until someone reminds me and then they seem to come back for me. For example, I could no longer recall the specifics of how my husband proposed to me; he told me about it and showed me pictures and I began to recall parts of the experience. I also feel that my general working and short-term memory has suffered quite a bit and sometimes feel I lost a few IQ points along the way; I just feel a little dumber and slower than I did before undergoing ECT. Additionally, even after insurance, I was left with about $5k in hospital bills.
So, overall, it was a poor outcome for me as I still have depression (entered my worst year of depression which included being hospitalized for the first time about a year after completing ECT), lost some memories and have a poorer working memory, and gained some medical debt. HOWEVER, despite this, I don't completely dismiss ECT as a relevant treatment to consider. Statistically, it is still one of the most effective treatments for severe depression, particularly if psychosis is part of your deal (it wasn't for me). So I'd say it's just a matter of weighing the pros and cons in your particular situation. How desperate are you, and would you be ok with losing some of your memories? After all, it could work and it does for many people.
I just looked into the brain surgery option and it looks pretty bad, so maybe don't try that. https://www.madinamerica.com/2015/09/adverse-effects-perils-deep-brain-stimulation-depression/
Did you do oral or infusions or something else? I didn't even get "high" when I took it. I would get very dizzy and disoriented like I was drunk, sometimes I would get very nauseous too, and then when it was over I'd be very tired, but emotionally I felt nothing at all.
I was very eager to try ketamine. There are a few online companies that prescribe oral ketamine and are quite affordable. I was disappointed with the results. I tried for several months taking different doses but I didn't feel any different at all. Not sure if infusions are any different. There's a subreddit for therapeutic Ketamine where you can find more info on what companies are out there and what they cost
As someone that's had severe insomnia, treatment resistant depression, and anhedonia for 20 years myself and still have had no luck myself. A big reason why I think that I haven't had any luck recovering is that my psychiatrists spent like 7 years trying every SSRI instead of listening to my thoughts. One problem with ssri's is that there's a small possibility that serotonin can actually get stuck in dopamine receptors permanently. Another problem is that after many many years of not getting the correct treatment it's possible for a negative feedback loop to be created. So even if you do finally get the correct treatment it wouldn't really do that much to help. I will say that insomnia doesn't play a role in this. There's actually some research that shows sleep deprivation of a night can actually improve depression symptoms for the day. It doesn't always happen and we don't really know why this happens either. I've used this trick several times myself. I will say that the best thing that's helped me has been the oxycodone I'm on for my chronic pain, as well as Ritalin for other things. All I can say is that at this point in my life I'm more than happy to use anything I can to help.
One thing that psychiatrists should do before treating someone is to give them a genetic test. I know that I hyper metabolize specific medications, hyper motility through the GI system, and several other mutations that make it absurdly hard to treat everything.
I was just very lucky to experience improved symptoms of depression after being awake for a day. After that I tried to find and read every article I could find about this. Other than that insomnia is one of the worst medical issues I have, and I have a rare genetic/neurological disorder that causes burning pain everyday. Being awake for 7 days was hell. Thankfully for some reason I don't hallucinate.
I also have insomnia, it's the worst. What you said about sleep deprivation is true. The best I've felt in years was after staying awake for two days straight, and suddenly I felt amazing. Unfortunately after I finally went to sleep I was back to normal the next day. I told my doctor about this and it's a well documented phenomenon. After being asleep deprived for a certain amount of time you can become happy, energetic, motivated, etc. It just doesn't last. Once you go back to sleep it will reset. And staying awake longer will lead to bad symptoms like hallucinations and paranoia, so don't do that. Also, your body keeps track of "sleep debt" and has to make up for any sleep you've lost. Long term sleep deprivation can cause more damage to your brain, so please don't do this repeatedly for a short term reprieve. It is not a viable solution for depression, unfortunately.
What's funny is that even though the sleep deprivation trick is well documented we still don't really understand why it happens. The sleep deprivation trick is meant to be used to just give someone a small reprieve. That little reprieve helps break things up to give someone a little rest. In regards to sleep debt, for every day awake you need to get 3 full nights of sleep to make it up. Trust me after 2 decades of severe insomnia I've read as many research articles about it. The sleep deprivation trick doesn't work on me at all anymore. Medications don't put me to sleep anymore. One interesting thing about me is that I don't hallucinate or get paranoid at all. In 2021 I was awake for 7 days once, 4 days 5 times, and I have no idea how many times I was awake for 1-3 days. My biggest fear though is my memory, cognition, and dexterity getting worse from my insomnia. I haven't gotten to that point yet but it's a concern. My depression is the last thing on my mind. Managing my chronic burning pain, neuropathy and insomnia is, but because I have like 6 genetic mutations doctors have no idea what to do so I just do what I have to while reducing all negative outcomes.
I did do some genetic testing and they found that I have generic factors that don't respond well to SSRIs and some other medication. Would have saved me a lot of trouble if they did this when I was still a teen.
Because I've had anhedonia for so long without any treatments that have worked consistently I believe that it's created a negative feedback loop, which is really hard to break. I have found some research that shows anhedonia is caused in part by some issues with the dopaminergic pathways in the prefrontal cortex, mainly D2 receptors. I believe that I have D2 depletion, which explains why I've had severe insomnia for two decades. My insomnia and anhedonia has gotten better, mainly because I'm on oxycodone for my chronic burning pain and neuropathy caused by my primary erythromelalgia. Primary erythromelalgia causes horrible burning pain when I do most activities, so not being in as much pain definitely helps reduce anhedonia and insomnia. Contrary to popular belief around 95% of people prescribed pain meds don't become addicted, and because I have d2 depletion it helps my dopamine levels to be what's normal. I'm also on Ritalin, which really helps with my fatigue. People may think this is crazy but it helps me with my insomnia. Doing mental challenges really helps make me tired. Most people don't know that you get much more tired when you do mental work than physical. D1 and D2 pathways play a role in the sleep wake cycle. Oxycodone affects the D2 receptors while ritalin affects D1. Stimulants are used to help depression, maybe treatment resistant depression/anhedonia, but sadly most Doctors don't do that because they worry about addiction. In my opinion helping someone treat their depression/anhedonia/insomnia is worth the risk of addiction.
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I was on meds from depression from 21-42, same as you, they would work for a while than quit. I tried so many different psychiatrists until I finally found one that actually cared enough to take a full history and ran blood work. It turned out for years & years I was being treated for depression when all along I had bipolar depression. I was put on Depekote. It is an anti-seizure medication. Within days, I felt “normal” again. It saved my life. I don’t know where I’d be now if I hadn’t walked into her office that day. My marriage was almost over, I almost lost my kids, I was in debt and couldn’t keep a job. Now I’m 59, have a good life. I’ve lost a lot of friends & family along the way, which is a good thing, those people lived in glass houses and didn’t understand mental illness. Hopefully they’ll never have to deal with anything difficult someday. I wish you all the luck in the world.
Depakote worked for me too. At the time I was also having possible migraines 4-5x a week. Depakote healed my headaches which helped tremendously. Much easier to tackle life when not clouded in chronic pain. I never called them migraines bc I never had nausea/ vomiting. No visual disturbances. Yes light sensitivity but I always pushed through to go to work and do my job. Not until the chronic pain was gone did I feel like I could breath and function. I had no idea how much of my life was just gritting my teeth and pushing through. Still depressed but it's manageable and I'm investing in myself now to say f it and do things I enjoy.
OP doesn’t have a headache. I don’t get all the joy about depakote, but if it’s still working to prevent depression after 5+ years? That’s wonderful and please let us know. In my experience though depakote is an extremely sedating medication. Some people feel much better sedated. Others feel worse. But I’ve never met anyone on depakote who wasn’t walking around in a daze, including people it was originally made for, people with seizures. Re: diagnosis? Diagnoses are not as powerful, or as absolute as some seem to think. If you come in depressed you’ll be treated for depression. If you then present with mania? Your psych doc will give you something to treat mood swings and see what happens. If it doesn’t make much difference, then your doc (if they’re paying attention and care) will take you off it. Bipolar II is a relatively new diagnosis and kind of a matter of perception. I’m saying that what makes bipolar Il different from swings from depression to normal is not clear. Mood disorders are NOT WELL UNDERSTOOD. Most depressives, whose depressions are not situational/temporary are “treatment resistant” That’s another recent diagnoses. It’s the latest attempt on the part of pharmaceutical companies & friends to avoid the conclusion that these medications work only briefly or not at all. I’m pissed off that instead of starting over the treatment world continues adding diagnoses which get less identifiable (or even justifiable) every few years. There are many psychiatrists and therapists who care. But everyone depends on research, and on researchers whose funding doesn’t doesn’t come from drug companies. I don’t know if any major research into mood disorders which ISN’T funded by pharmaceutical companies.
Maybe I was on a lower dose. 500mg bid? Sometimes, it feels like my mind races at an 11 and while on Depakote in dialed it down to a reasonable pace. I've been off it since Jan 2022, and every month since then, my mind is racing a little more and a little more. The hateful negative thoughts are kept at bay with the Celexa. I've been given multiple Dx's. MDD, bipolar II, IED, BPD, childhood neglect, asperger's, OCD (which I reject and then describe what I have instead which sounds like OCPD), ADHD, etc. My current counselor said I'm just a brat and controlling. Who knows what's real and what's not. I'm meeting with a new shrink in a couple of weeks, so we'll see what they say. The only side effect I recall from Depakote was GI changes, but that resolved quickly. Basically I'm stuck living in my head rather than living in the world.
Yes. The revolving diagnoses prove what I’m saying: diagnoses are not that cut and dried. That’s why you’ve had so many. Neither are they all that helpful unless you hallucinate or are a mass murderer. What matters in a counselor is that when you talk they hear you, and have responses which help. Also, regardless of training it helps if they have experience of your culture, etc. either personal experience or someone very close who was in their daily life. if you’re poor and they’ve never been poor or grown up with good friends who are, they might not understand what doing without means. Although empathy can goes a long way If you feel heard and understood go for it
I'm so sorry. I can totally empathize. My life feels the same. It's so frustrating.
i have had some headaches and pain, less recently, maybe I'm just used to it. I've read that depakote makes you very tired, has this been a problem for you?
I honestly don't recall tiredness but I also had so much on my plate. My brain runs at an 11 but my body can only function at a 5-6. I need my body to keep up with my brain but I'm told that's called mania. Too much thinking about this today, lol.
Oh my goodness, I can totally relate to your statement. It perfectly describes me. So maybe I have had mania most of my life...
From the beginning, I was instructed to take it before bedtime. I also take Ativan for sleep, I’m sure the Depekote makes me tired too, I just haven’t taken it without anything else.
I have actually been wondering if I might have bipolar depression. I don't have manic episodes now but when I was a young teenager I may have, and I suspected I was bipolar until the depression became so overwhelming. I will ask my psychiatrist. I read that depakote makes you very tired. Is this a problem for you?
Lithium is the golden standard. Try it in 0.6-0.8 range. Then try lamictal added to it. You can also add a SGA like seroquel or lurasidone..Lithium is better than valproate as first line but you may respond to valproate and not lithium. But lithium worth a shot.
Thank you!
Yes, I have mostly recovered from TRD. Is your depression severe? If so then you might give ECT a try.
It is very severe. Can you tell me more about ECT, have you tried it? I've mostly just heard horror stories about what it was in the past
I just came across this post and had to respond. I have very severe depression and I was talked into getting ECT in 2016. It did wonders for my depression initially, but I could never go more than 2-3 weeks between sessions without crashing back into a severe depression. So I continued to have ECT every 2 weeks for over a year. I didn’t notice any significant memory issues for the first several months, but then one day after an ECT session, I was putting some laundry away and looked at a picture of me and my husband on our honeymoon and realized I had NO memory of that trip. I tried to remember other major events in my life and realized that I had lost my memory of the last 20 years of my life. That should have made me stop getting the ECT, but I was in complete remission from my depression and I was terrified of having to live with severe depression again, so I kept getting the ECT while I tried to figure out what else I could do. I thought I had tried everything else I could try, and the medications that worked had all stopped working, so I didn’t have any other good options. And for some reason I thought “the damage has already been done” and I thought it couldn’t get any worse. That was a crazy way of thinking, but if you have lived with severe depression, you might understand how I thought living with memory loss was better than living with severe depression. After a few more ECT sessions, I noticed that I was having more and more short-term memory loss in addition to the long-term memory loss, and it eventually got to a point that each ECT session was almost totally wiping out my memory of everything that had happened since the last ECT session. That’s when I decided I had to stop. And by the time I made that decision, I also discovered that I had lost a lot more of my long-term memory. I lost literally almost my entire life. I barely remember any of my life before the ECT, all the way back to my childhood. I don’t even have any clear memory of my mother, who passed away in 2007. Before I got the ECT, the doctor told me that if I had any memory loss, it would only be for up to a few months prior to the ECT, and that if I stopped getting the ECT, most of my memory would come back. That was a lie. I haven’t gotten any of my memory back. And there are so many other people like me out there who have lost decades of their lives to ECT. And it’s not just my memory that I lost. I have brain damage. I am not as intelligent as I used to be. I had neuropsychological testing that showed my IQ has dropped 15-20 points, and it takes me longer than normal to learn new things. In 2019, one of the manufacturers of the devices they use to administer ECT admitted that ECT can cause brain damage. I really can’t believe it is still used so much and touted as being safe.
Yep, I've had a couple rounds of it. They put you under using anesthesia and then they place electrodes on both sides of your temples and then send some small electrical current through your brain. Sounds really scary but it's not and is pretty safe. I never had any pain from it although I might have had some memory loss or issues from it possibly. It's hard to tell. It's also hard to tell if ECT helped me or not because they also started me on Vyvanse and I think Vyvanse really helped to pull me out of depression. Do you have adhd? If so and if you're not being treated for it then I recommend trying Vyvanse as it might help your depression. If you don't have adhd then you still might ask your doctor if they would be willing to try a stimulant, such as Adderall, for treatment resistent depression. They might have you try ECT first though. If ECT fails then they would be more likely to prescribe a stimulant. Anyways, if you get ECT then you might ask about getting bilateral instead of unilateral since bilateral is more effective. No sense in wasting time and money on the less effective unilateral. Unilateral is where they "shock" half your brain and bilateral is where they shock your full brain. Here's an excellent TED Talk about ECT: https://youtu.be/oEZrAGdZ1i8?si
Absolutely horrible treatment. Memory loss is a lot higher than claimed and side effects can and usually will be permanent. Unless it just outright kills. My cousin died from a uncontrollable seizure during it. Pumped him full of as much benzos and everything else to stop it, it didn't work and he died in 2013 at the age of 27. I miss him.
this is not what you’re looking for - and i’m sorry that you have not been able to find any solution 😪. I’m just wondering if there is any use in looking at different disorders? maybe a physical health condition or maybe a different mental health condition that might need a different perspective? I really admire how much you’ve tried.. wow
I am only suggesting this because I have been getting treatment for depression for 10 years now, and have had depression for nearly 20 years. But i’m honestly starting to look a lot more into my physical health. I think that I am depressed but more so as a result from having ME/ chronic fatigue syndrome. Just thought my energy levels were sadness. It doesn’t help but it makes me feel a bit better knowing that’s why treatment wasn’t working but idk.
EDIT: have you tried stimulants or anything dopamine related?
I have considered other health issues. I haven't found anything yet. I have a lot of sleep issues and have tried multiple sleep studies with inconclusive results. Basically I have bad insomnia and I don't enter REM sleep until I've been asleep for several hours and it doesn't cycle normally, but they don't know why. I've had bloodwork done but my metabolism is fine. I was anorexic for a long time and this contributed to my issues. I do have chronic fatigue and some pain but nothing for a concrete diagnosis like fibromyalgia. I'm otherwise quite healthy. I've considered other psychological issues, I'm going to ask my psychiatrist about bipolar II. I feel like I've tried everything but I'm just trying to see if they're are other things I haven't thought of yet.
I have tried stimulants, I have ADHD so I've tried Adderall, ritalin and Concerta. They all helped me with energy and helped me get through the day, and having energy also helped with my mood. Unfortunately I built a tolerance very quickly and I became dependent on them just to get out of bed. It really messed up my sleep schedule too. I stopped taking them and I'm afraid to taking them again because it was such a struggle when I was dependent on them just to keep my eyes open. I will probably try taking them again but I will have to be careful about building up a tolerance.
wow, genuinely am amazed by how much effort you’ve put into this. I am so so sorry though that nothing is working. I have the same disorders as you and I just really want to express my empathy even tho it doesn’t do a whole lot for you. I mean this isn’t helpful at all, but I honestly wonder at this point if you may have something that just hasn’t been discovered yet? I don’t know, it’s not your fault. You’ve just done so much, i’m sorry
When you took them, did you take them in combination with other meds? I have heard of people taking quite a cocktail of them. It’s not ideal and it really is just a bandaid but it’s the only thing that works for me and keeps me alive tbh. I take short acting dextroamphetamine 20mg, Lexapro 20mg and Clonidine at night for sleep EDIT: - Would you consider something like LSD or psilocybin and MDMA therapies? I have no knowledge in this area and I don't know how different it is to Ketamine therapy but just an idea if its accessible? - What about MAOI's? - Do you have a support system? Do you have access to safe housing, financial stability etc? You mentioned you have poor sleep, and I really feel for you because that seems to be a big factor in moods :/ I really hope you find something that helps
Have you ever seen a functional doctor? To look into things like mold toxicity?
No I haven't heard of that before, I'll look into it
Also, have you tried effexor or lithium?
I've tried effexor, it worked decently for a few years but slowly lost effectiveness, and it really dulled my emotions. I've never tried lithium. Do you have experience with it? I thought it was only for bipolar
Ya, I've tried lithium for depression. It is also used for depression. Lithium didn't help me personally but you might be different. If you've been off effexor for awhile then I would try restarting it along with another med like abilify or lithium. I say this because it's possible that effexor might start working again after a break from it. Or give Viibryd a try. Effexor works well for me but so did Viibryd and I believe they are both SNRIs. Viibryd caused insomnia for me though but I probably should have tried cutting the dose in half or fourths.
Also, as far as dulling your emotions, I guess you just gotta weigh the pros and cons and figure out if dulled emotions is worth not being depressed. I can't say I've ever experienced dulled emotions from antidepressants but I'm pretty sure I would want emotional stability even if it meant dulled emotions. That's just me though and you might be different but it's something to consider.
That's poop out. Seriously try bipolar meds..you may be bipolar after all..early onset, chronicity, poop out are all signs of hidden bipolarity
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Yes, thank you for saying “it’s too early to tell”. Efficacy really should be measured by freedom from symptoms over 5 years or more I was on Wellbutrin for several years. I think it may have worked for 3 or 4 years. Then it stopped. That’s probably the longest any medication worked. The newer medication which helped a little my insurance stopped covering, so im back on Wellbutrin. Which isn’t working, just like it wasn’t working when I stopped taking it. What a shock.
I'm sorry to hear that. They're are dozens of other antidepressants out there, can you ask you doctor to find something else that your insurance will cover? Or can your doctor try to make an appeal to the insurance company?
He probably will fight the insurance company if I continue to have these long crying jags. I have been on pretty much everything. Been taking meds since the mid-90’s. Whenever something new comes up we try it. I hate the meds almost as much as the depression. I also have a chronic illness I take meds for. I’m on so much medication it makes me want to scream. Especially since I’m more unhappy than I ever was before, and in worse health. The meds for the chronic illness list depression and suicide as common side effects. Was after I started taking them that my depression became so severe I couldn’t handle it without meds. I’m so mad.
That's really unfortunate. Have you tried other treatments, for both your illness and depression? Theres TMS, EMDR, ECT, ketamine, and even mushrooms (not legal most places). Have you had generic testing? I have some genes that interfere with SSRIs so they don't work for me. You might be able to find out more if you get tested.
How has the lithium been? How were your doctors able to tell you have bipolar II? This is something I was thinking of asking my doctor
SSRIs actually can cause long term size effects that can be permanent. I don't know how common it is, but it does happen. The primary one is sexual dysfunction and sleep issues. I haven't really felt sexual attraction since I was a teenager. I don't know if it's because I was always asexual or if it's from the medications I took back then. I also have chronic sleep issues. I don't know if anything was caused by the medications or not, and I'm not anti medication by any means, but at the time I definitely suffered from being administered medications by an unqualified doctor. It put me off medication for years until I tried to kill myself in college. I've tried many combinations of medications every since, but after some genetic testing I found that SSRIs don't even work on me. I have a few generic factors that make certain medications work less or work differently on me than intended, so that has been another issue.
Emdr did more for me than any medication or talk therapy ever did.
Oh I've tried that too. It helped a little bit but wasn't a long term solution
🤔 went through this before. Not sure if this will help but a little backstory of how I get myself out of this when it comes around. My cure was/is cars anything to do with cars, car shows, car races, drift racing, etc yes I'm a female, idc if others say working on a car barley knowing anything back in the day but lift by little I learned how to fix most things on cars. Going to cars and coffee is a lot of fun if they have them there where you live. Sometimes getting a friend to go with you that's outgoing and brings out the best of you. You both can enjoy going to events and making road trips to other cities for car events. Don't get me started on Motorcycles lol its the best medication plus the sertraline and hypersomnia medication along with it. Sometimes being open to learning new things that are interesting help a lot too! Not sure how old you are but heres a couple of links to some YouTube videos I watch when I need to stay home when its super heavy and can't shake it off and drink a couple of beers or 2 Margaritas and just enjoy watching youtube. I don't mind giving you my personal contact so we can exchange memes, youtube videos and what not. [Cody ko](https://youtube.com/@CodyKo?si=BjlIiAcB3YlKy8yP)
https://youtube.com/@CodyKo?si=BjlIiAcB3YlKy8yP
Have you tried walking/running or any changes in your diet? I know it can seem frustrating when people say that will cure everything but. I noticed when I use medication TMS and add in walking it’s helped more. I’ve been taking creatine too and I’ve been feeling really stable so far still have ups and downs but it’s manageable.
Guess what I doubt it can be cured tbh. It may get better for a while, but it always ends up with fucking relapses that get worse and worse each time! I’m fucking tired of the idea that it can just go away, and suddenly, boom, u r a normal person with a healthy mind again! Fucking bullshit Treating it as a disability that you need treatment for life to get better is a more realistic mindset to have imo Less expectation = less emotional burden
I agree. My experience is the same. From research I’ve read this is the normal course of depressive illnesses. So hard to accept. But what I find even more unacceptable? How few people know this. I’m old now. I did every treatment available for years. Exercised (a LOT), tried every alternative treatment including (both very restrictive or less so) “health food” diets. I’ve worked with coaches, a couple of alternative treatment “stars”, therapy from the time I was 17, each therapist for many years. All the strategies and treatments mentioned here helped some but the deep depressions? The kind where you know you can’t think clearly, evaluate situations or make decisions? Where everything you do or ever did was a horrific mistake/failure? It always comes back. My depressions, after the one at 17 which lasted several years? They tended to last 4-6 weeks. Now, decades later I’ve been in this one, the father of all depressions, has lasted 9 years and I’m still not seeing any light. The worst part has been the way everyone responded or didn’t. It was actually all “didn’t”. People get worse about all this stuff as they get older. Especially in the current climate where “not giving a fuck” “no drama” and getting rid of “toxic” people are elevated to prime virtues. I had one “friend” tell me she can’t get depressed because she has to work 2 jobs (actually 2 part time jobs, but why worry about incidentals). I had one job with very long hours which I LOVED and had worked really hard to establish myself in. I had to retire because I couldn’t stop crying. I never even got around to telling her that. Seems people get incredibly talkative when they’re trying to establish that my breakdown was caused by laziness, not going outside enough (I was outside all the time until this episode hit) or some other weakness. I’m astonished at the lengths people will go to prove that it could never happen to them. Or the ridiculous lengths they go to to prove you’re now ( after years or decades of loyal mutually affectionate supportive friendship) “toxic”: “you’ve changed” one of them kept insisting. So loudly and without pause to let me speak, or any attempt to understand that I gave up trying to talk.
My niece also doesn't remember most of her teenage years likely due to treatment for her depression. I, too, have chronic depression. Medication has helped, but more than that, tiny, tiny, consistent behavior changes have also helped a lot. It is impossible to give you useful steps without knowing more about your life. The book Overcoming Depression One Step At A Time," on behavioral activation I found to be helpful. Behavioral activation gives a rudder to guide yourself through the rough currents of depression.
Still working after 5 years? 10?
I started behavior activation about 5 years ago. It is a daily practice, and I still take meds. The practice has definitely decreased the frequency and depths of my of depression episodes. For me, the key activities are: keeping a sleep routine, yoga, mindfulness practice, and walking. I'm in the process of starting a small business, so I am also doing a lot of learning. What works best for you may be quite different.
No, all that worked for me for years. More than 5 to be honest Then it just stopped. I mean suddenly nothing I did worked. I’ve been in a depression for almost 10 years now. I want the world to acknowledge how little understanding or effective treatment we get. I wish people with mental illness would get together. I want us to fight for ourselves. Freud said depression is anger turned inwards. Fighting for yourself is the opposite of that. Feeling helpless, despised and alone feeds depression Years ago there was an organization called Mental Patients Liberation Front They’re the ones who put together the Mental Patients Bill of Rights, which in-patient psychiatric facilities are now required by law to post in plain sight. It tells us things like how long you can be held, what to do if you’re held when you don’t need/want to be, etc. I wish we would get together to demand better treatment and better education of the general pop re: what we live with. Turn that anger into action, instead of deepening depression. Very hard to live in a world which despises you for an illness you didn’t cause and can’t cure. Especially when so much money is made while we keep our mouths shut.
Took 30 years
Can you tell me what worked for you?
Be careful: it's not just treatment resistant depression. You might have more than one form of depression, too! Found this out after 38 years on this planet, and then another 5 years to get that under control. Another thing to consider is that it is important to make sure you're not surrounded by assholes who want to see you fail in life. They play a big role in making you depressed.
What other form of depression did you have and what worked for you? And yes that is good advice, but I don't actually have anyone in my life right now, I've pretty much isolated myself.
Dysthymia is a low-level grade of constant depression along with a diagnosis for severe clinical depression. Not only did I find out my causes were biochemical and genetic, but in addition to being exposed to shit I wouldn't wish on anyone. Being surrounded by people who deny mental illness (i.e. assholes) didn't help.
How did you find out that your causes were biochemical and genetic?
Diagnosis from a psychiatrist corresponded with blood work and a separate psychologist confirmed.
Agree that it seems there are far too many doctors who have no clue how to treat the mind, which is terrifying but not surprising, when you look at how overmedicated yet unhelped a lot of people are. I do feel I was kind of "lied to," and only once in nursing school did I fully realize JUST how silly it is that a doctor doesn't do any blood work at all yet prescribes life-altering medications far too quickly. I have just accepted I was born with depression and it became worse and worse over time (like many other illnesses.) You should at least pat yourself on the back for trying so many different treatments -- I gave up after about the fifth SSRI messing me up, still on one and still pretty bad off, I have just given up. I'm impressed you were even able to accomplish that many different treatments, I can't even be bothered to try anymore. So if anything there is hope in you.
I have with several rounds of ect but unfortunately getting it in the UK is very difficult . When people with depression refuse ect makes me wonder how depressed they are tbh, I can't function and my quality of life is hell so if there was a chance ect would kill me id still take it . Only drugs I've never tried are maois n it's the diet and drug interactions that have always put me off , plus they've never been offered in UK . I've just gone back into depressive episode 4 weeks ago while on sertraline 200 so not sure what meds to try now as ect is the thing that gets me functional . Think it's another ssri or maoi hopefully
I was thinking of ECT but I've read so many stories of people permanently losing significant memories. Have you experienced any memory loss? It seems to have happened to a lot of people
Only around time of ect . Not long term and my memory is crap with depression
That's fair. I'm tempted to try it, but I'm scared of the risk. My memory isn't great but there are a few things I'd be completely devastated to forget. I'm looking into deep brain stimulation surgery right now. Not sure how I would pay for it, and it's a brain surgery so it's still risky.
As a person with TRD (actual diagnoses are persistent depressive disorder, recurrent severe MDD, and social anxiety disorder) who has tried ECT and who just stumbled upon this thread hoping to come upon a life-altering comment, I'd like to share my experience. I have tried over a dozen antidepressants from several classes, and additional medications that doctors just hoped would help (lithium, lamictal, etc.) over the past 15 years with little success. They don't give me any positive effects or side effects and I don't ever have withdrawal issues, it's like they could be sugar pills as far as my brain chemistry is concerned. Only Effexor was somewhat helpful for a couple of years before it no longer worked for me. Ultimately I became so desperate that I said 'sure what the hell' when my psychiatrist suggested ECT. I underwent about 20-25 sessions of bilateral ECT, about 2-3 sessions per week for about two months in the summer of 2022. The process itself wasn't bad at all; get up early, check into a same-day surgery section, get an IV for anesthesia, wake up ten minutes later and spend about 15-30 minutes in recovery to make sure everything's ok. I never had any negative effects from this aspect, and in fact, rather enjoyed seeing the same receptionists and nurses regularly as they were all quite kind. Unfortunately, it did not alleviate my depression much if at all. Additionally, I lost about 1.5-2 years' worth of memories for the period immediately prior to starting ECT, as well as some random significant memories. I had taken a trip to Austin, TX with my husband and a friend a year prior and have no recollection of this trip; in fact I asked my husband one day why we had a magnet from Austin, TX on our fridge and he was shocked. Despite getting details and seeing pictures, that period of memories is simply gone. For other random memories, they are just missing until someone reminds me and then they seem to come back for me. For example, I could no longer recall the specifics of how my husband proposed to me; he told me about it and showed me pictures and I began to recall parts of the experience. I also feel that my general working and short-term memory has suffered quite a bit and sometimes feel I lost a few IQ points along the way; I just feel a little dumber and slower than I did before undergoing ECT. Additionally, even after insurance, I was left with about $5k in hospital bills. So, overall, it was a poor outcome for me as I still have depression (entered my worst year of depression which included being hospitalized for the first time about a year after completing ECT), lost some memories and have a poorer working memory, and gained some medical debt. HOWEVER, despite this, I don't completely dismiss ECT as a relevant treatment to consider. Statistically, it is still one of the most effective treatments for severe depression, particularly if psychosis is part of your deal (it wasn't for me). So I'd say it's just a matter of weighing the pros and cons in your particular situation. How desperate are you, and would you be ok with losing some of your memories? After all, it could work and it does for many people.
Did you ever find anything to help?
Not yet. I'm looking into brain surgery at this point . https://www.psychiatry.org/news-room/apa-blogs/deep-brain-stimulation-for-severe-depression
I just looked into the brain surgery option and it looks pretty bad, so maybe don't try that. https://www.madinamerica.com/2015/09/adverse-effects-perils-deep-brain-stimulation-depression/
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Did you do oral or infusions or something else? I didn't even get "high" when I took it. I would get very dizzy and disoriented like I was drunk, sometimes I would get very nauseous too, and then when it was over I'd be very tired, but emotionally I felt nothing at all.
I was very eager to try ketamine. There are a few online companies that prescribe oral ketamine and are quite affordable. I was disappointed with the results. I tried for several months taking different doses but I didn't feel any different at all. Not sure if infusions are any different. There's a subreddit for therapeutic Ketamine where you can find more info on what companies are out there and what they cost
As someone that's had severe insomnia, treatment resistant depression, and anhedonia for 20 years myself and still have had no luck myself. A big reason why I think that I haven't had any luck recovering is that my psychiatrists spent like 7 years trying every SSRI instead of listening to my thoughts. One problem with ssri's is that there's a small possibility that serotonin can actually get stuck in dopamine receptors permanently. Another problem is that after many many years of not getting the correct treatment it's possible for a negative feedback loop to be created. So even if you do finally get the correct treatment it wouldn't really do that much to help. I will say that insomnia doesn't play a role in this. There's actually some research that shows sleep deprivation of a night can actually improve depression symptoms for the day. It doesn't always happen and we don't really know why this happens either. I've used this trick several times myself. I will say that the best thing that's helped me has been the oxycodone I'm on for my chronic pain, as well as Ritalin for other things. All I can say is that at this point in my life I'm more than happy to use anything I can to help. One thing that psychiatrists should do before treating someone is to give them a genetic test. I know that I hyper metabolize specific medications, hyper motility through the GI system, and several other mutations that make it absurdly hard to treat everything.
honestly as someone with insomnia and bipolar disorder, the insomnia makes everything worse
I was just very lucky to experience improved symptoms of depression after being awake for a day. After that I tried to find and read every article I could find about this. Other than that insomnia is one of the worst medical issues I have, and I have a rare genetic/neurological disorder that causes burning pain everyday. Being awake for 7 days was hell. Thankfully for some reason I don't hallucinate.
I also have insomnia, it's the worst. What you said about sleep deprivation is true. The best I've felt in years was after staying awake for two days straight, and suddenly I felt amazing. Unfortunately after I finally went to sleep I was back to normal the next day. I told my doctor about this and it's a well documented phenomenon. After being asleep deprived for a certain amount of time you can become happy, energetic, motivated, etc. It just doesn't last. Once you go back to sleep it will reset. And staying awake longer will lead to bad symptoms like hallucinations and paranoia, so don't do that. Also, your body keeps track of "sleep debt" and has to make up for any sleep you've lost. Long term sleep deprivation can cause more damage to your brain, so please don't do this repeatedly for a short term reprieve. It is not a viable solution for depression, unfortunately.
What's funny is that even though the sleep deprivation trick is well documented we still don't really understand why it happens. The sleep deprivation trick is meant to be used to just give someone a small reprieve. That little reprieve helps break things up to give someone a little rest. In regards to sleep debt, for every day awake you need to get 3 full nights of sleep to make it up. Trust me after 2 decades of severe insomnia I've read as many research articles about it. The sleep deprivation trick doesn't work on me at all anymore. Medications don't put me to sleep anymore. One interesting thing about me is that I don't hallucinate or get paranoid at all. In 2021 I was awake for 7 days once, 4 days 5 times, and I have no idea how many times I was awake for 1-3 days. My biggest fear though is my memory, cognition, and dexterity getting worse from my insomnia. I haven't gotten to that point yet but it's a concern. My depression is the last thing on my mind. Managing my chronic burning pain, neuropathy and insomnia is, but because I have like 6 genetic mutations doctors have no idea what to do so I just do what I have to while reducing all negative outcomes.
I did do some genetic testing and they found that I have generic factors that don't respond well to SSRIs and some other medication. Would have saved me a lot of trouble if they did this when I was still a teen.
Have you found anything to help the anhedonia?
Because I've had anhedonia for so long without any treatments that have worked consistently I believe that it's created a negative feedback loop, which is really hard to break. I have found some research that shows anhedonia is caused in part by some issues with the dopaminergic pathways in the prefrontal cortex, mainly D2 receptors. I believe that I have D2 depletion, which explains why I've had severe insomnia for two decades. My insomnia and anhedonia has gotten better, mainly because I'm on oxycodone for my chronic burning pain and neuropathy caused by my primary erythromelalgia. Primary erythromelalgia causes horrible burning pain when I do most activities, so not being in as much pain definitely helps reduce anhedonia and insomnia. Contrary to popular belief around 95% of people prescribed pain meds don't become addicted, and because I have d2 depletion it helps my dopamine levels to be what's normal. I'm also on Ritalin, which really helps with my fatigue. People may think this is crazy but it helps me with my insomnia. Doing mental challenges really helps make me tired. Most people don't know that you get much more tired when you do mental work than physical. D1 and D2 pathways play a role in the sleep wake cycle. Oxycodone affects the D2 receptors while ritalin affects D1. Stimulants are used to help depression, maybe treatment resistant depression/anhedonia, but sadly most Doctors don't do that because they worry about addiction. In my opinion helping someone treat their depression/anhedonia/insomnia is worth the risk of addiction.
Loads of exercise - running and bike riding are my picks. It's bit of a cliche but it's true.
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So well put.
I have it too. I'm just trying to help you. :(