Posted by LostBoyinNCReturns on March 17, 2012, at 10:11:07
In reply to deep sleep, antidepressants, posted by Christia on December 26, 2011, at 13:58:08
Hi,
As someone who is former TRD, I have credibility on this subject. I would say if you have failed adequate dosage of the stronger meds like Parnate and Cymbalta and others, the odds of any AD helping your depression all that much are low.
I would begin looking at an altogether different avenue to get you out of what sounds like TRD. Have you been to a sleep medicine doctor yet and gotten thoroughly screened for sleep apnea? Even mild sleep apnea can make depression worse or even create depression.
I would get cozy with a good sleep medicine physician who accepts whatever type of insurance you have. Also, many people have to buy their CPAP gear out of pocket, which is expensive but it is worth it as you might get well enough to get a job...I assume taking such strong meds as you are taking you are unemployed?
Other "different avenues" include: ECT, a different kind of mood disorder such as bipolar which ADs usually worsen instead of help, endocrine deficiencies (thyroid being the most common, testosterone common in middle aged and older males), simple anemia and iron deficiency (many GPs no longer bother to treat or even diagnose unless the anemia is severe.
All sorts of things can cause TRD.
Finally, a bad life environment can create a situation where you will not get better no matter what you do. Unfortunately, with the possible exception of ECT, none of these meds really work all that great if you environment totally sucks. Severe financial stressors, chronic unemployment, obesity and poor overall health, negative family members, abusive relationships can all combine to create a "living hell" sort of environment that just perpetrates TRD.
Solution? Fix your negative environment. Dump negative family members. Dump abusive relationships, if unemployed get a part time job or maybe even volunteer somewhere, if under severe financial stress such as credit card debt or other debt consider something fast and dirty such as bankruptcy.
Even a bad geographic location, where the area is economically depressed and educational opportunities are low, can contribute to TRD.
Usually it will take a two pronged approach to TRD, a strong biological one plus improving your "life situation" to something more positive.
Also, chronic depression can gradually slide you into a negative life environment. This happened to me and it took me a move to another city to recognize it had happened to me. I now am aware of the critical need for a positive environment and stress management for TRD to be successfully treated.
Eric
poster:LostBoyinNCReturns
thread:1005599
URL: http://www.dr-bob.org/babble/neuro/20110604/msgs/1013298.html