Posted by Racer on May 23, 2004, at 14:34:36
In reply to Re: treatment resistant depression, posted by Ilene on May 23, 2004, at 6:55:37
Man, that sounds more than rough. I can relate to the feeling that nothing is going to help, and that it's just time to make that last move if this is as good as it gets, but I don't know that any one thing is going to fix it at this point for me, and probably not for you, either. Isn't that a b**ch? Just when we most need something that can give us a little relief, we get to the point that we have to start fighting hardest. I'm there right now, myself, so I know how hard it is for me but can only imagine your pain.
I've got a few questions for you to think about, that might or might not help you decide what your next step is. I hope considering your answers helps you.
First of all, you've been seeing a therapist and aren't finding it helpful. Could it be that the therapist you're working with isn't the right fit for you right now? Maybe another individual or another therapeutic approach might help you find some better coping strategies for your distress? That's the first thing that comes to my mind after reading your post.
I don't know which other drugs you've tried over the years, so I can't really say anything about what to try next. Maybe an MAOI? Maybe a TCA? Maybe another SSRI or other first line drug? Maybe talk to your pdoc about going symptom by sypmtom to get you some relief before starting up again on the search for the drug or combo that will allow you to get back to living your life? For an example of what I mean by that last one, I'm so agitated and wound up and frightened out of my mind about going back into the pdoc's office and getting handed another drug that it's all I can do to be safe right now. Instead of continuing on in the same rut of knocking heads over which anti-depressant to try next, I'm going to ask him to address just that anxiety for now. It's asking for a bandaid to put over a gunshot wound, but I'm hoping that giving me a little breathing space from the distress the treatment itself is causing me might allow me to get back to where I can engage and be a little more rational about his choices for me. Does that make sense? I'm asking him to relieve the anxiety that is interfering so much in my ability to engage in my own treatment.
Also, although this is obvious it's also often overlooked: get a full physical workup, including full blood panels. This fits in with what Ilene mentioned, as thyroid function tests are not a routine part of most annual physicals. Make sure there isn't some underlying physical problem contributing and complicating your depression. This is the hardest thing in the world to do, when you're so depressed, but it's really important. What if you have an easily treated depression -- but it can't be treated because of a subclinical infection that ten days of antibiotics could fix? Hard as it is, it's worth it.
Another thing to think about is EMDR. I haven't tried it, but would like to. From what I've read, it seems to make a very significant difference for a lot of people. It's not magic, but if nothing else is working, it's worth a try.
Last thought is clinical trials, if you've got a research facility near you. I'm near enough to Stanford that I'm trying to get enough UMPH up to contact them. Most of the universities that have research programs post their current research areas online, so you can try local university websites to see if anything looks as if it might sound promising.
I'm sorry I can't give you a good, easy answer, like, "Take [x] and it will fix this." I hope that I've offered something here, though, that might give you some ideas.
Best luck to you, and be well.
poster:Racer
thread:349830
URL: http://www.dr-bob.org/babble/20040521/msgs/349904.html