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Treatment resistant depression
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star_blazer posted:
I am getting desperate. Have had major depression and severe anxiety my entire adult life and all the way back through my teens. For over a decade I self medicated with alcohol, which was very effective at temporarily relieving the symptoms. As my tolerance got higher and higher my drinking spiraled out of control until I was blacking out almost every night and passing out. Had 3 suicide attempts during this time, and was very lucky I didn't kill myself with the drinking alone.


The doctors told me medication would not work while drinking alcohol and that I had to get sober. I have been sober almost a year now and still no medication is working. I've been on at least a dozen now including different SSRI's, an MAOI, Seroquel, add ons like Lithium, and most recently a tricyclic, none of them have provided any significant relief. I still score in the severe range of the depression/anxiety test.


I next tried a small hand held device called the Fisher Wallace device, which uses we sponge contacts placed on the head to deliver weak electro stimulation to the brain, that also did nothing for me. I tried talk therapy, which wasn't of much benefit. I looked into rTMS and they thought that the treatment wouldn't be powerful enough and I was severe enough that I better bypass that and go straight to ECT, which I did. About a dozen treatments, both unilateral and bilateral, provided a little bit of relief, (nothing major) but it quickly faded after a week of stopping treatment and I was right back down to absolutely miserable.


There is the DBS treatment but looks like that is still in clinical trials and not available to the public as a means of treatment yet. I am willing to try anything at this point. Is there any treatment or medication I may have left out? Something I haven't tried yet? Nothing is helping and the long I go on the more I feel like alcohol was the only thing to bring any relief and it is getting harder and harder not to go back to drinking. I have powerful suicidal thoughts every day, constantly. My symptoms have gotten so bad that I have been forced to discontinue working. I feel like the only thing keeping me going at my job was the alcohol, it allowed me to decompress and deal with the relentless stress but now that the alcohol is out of the picture it just got worse and worse until I felt like I was on the verge of a complete breakdown. I can hardly bring myself to get up and face the day. I want to drink so bad every day, I want that quick easy relief so much that I have to grind my teeth and fight to get through the day without giving in.


Interesting side note, my mother brought up that schizophrenia runs in her side of the family and while I do not hear voices or exhibit any of the 'positive symptoms' — I am almost an exact fit for the 'negative symptoms' — in fact after some research with google discovered that negative symptoms of schizophrenia are sometimes misdiagnosed as major depression because the two are so similar. According to what I read online it is possible to have just the negative symptoms of schizophrenia without having the positive symptoms. Hopefully in the next week or two going to a group that specializes in schizophrenia to be re-diagnosed and see if there are options I haven't explored yet. Perhaps this is a piece of the puzzle that has been missed. I will try to remember to post my findings here, perhaps this information will be helpful to someone else.


Thanks for taking the time to read... and if there are any treatments or options I have missed... please post a reply and let me know. Thanks in advance.
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Demons2011 responded:
Star_Blazer, the only thing I didn't see was CBT, Cognitive Behavorial Therapy. It's helping me some, but the med side effects where much worse than the depression. As in a vegetable. I haven't been "approved" for ECT, don't have the money anyway. So like you struggling every day trying to walk on the green side of the grass.
 
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star_blazer replied to Demons2011's response:
Thanks Demons. I have had talk therapy, I think it was specifically termed psychotherapy, not sure how similar that is to behavioral therapy. I have heard of CBT although I never tried it because I already had a form of talk therapy that was highly expensive and really didn't do much good.

Thanks for the response and best of luck.
 
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Thomas L Schwartz, MD responded:
Hello-
1) you have mentioned a few meds, but there are actually many other types of meds with different mechanisms you can try
2) you did not mention bona fide psychotherapy, have you done cognitive-behavioral or formal psychodynamic psychotherapy
3) Continue to investigate the schizophrenia idea and some of the medications that are used there


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