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901137 tn?1267626189

Treatment Resistant Depression

I have treatment resistant moderate depression. (My doctor characterizes it as "moderate" as I am able to function on a daily basis. While saying this he acknowledges that it doesn't feel moderate to me)
I tend to keep the hurt to myself. I was wondering if there are others who are experiencing the same situation.
Mike

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901137 tn?1267626189
Having struggled with treatment resistant depression for more years than I can recall, I understand the frustrations you have. Personally I am less focused on remaining positive and more focused on remaining determined. To stay positive after years of disappointment is a bit of a stretch however I can remain determined to not give up the search.

As for what other people say about different medications or treatments, I take it for what it is. It is their experience that may or may not apply to me. We are all individuals and each of our situations is unique. I value and learn from others but don't assume what is good for them will be good for me.

What I do try and do is keep my doctor up to date with what is working and what isn't and then look for new directions.

My heart goes out to you. Let's both keep up the good fight.

Mike
Helpful - 0
301640 tn?1302652334
i have chronic disphermia depression and im on anti depressents im trying not to think bad thoughts but change my thoughts and try to look positive people say  med has helped others say it makes me up and down
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901137 tn?1267626189
Thanks Pat... I so much appreciate your good thoughts. I will let you know how things work out. If things don't work out I will find something else to try. All I want to do is keep my ability to fight this thing(?). Mike
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874521 tn?1424116797
I pray that your decision has a positive outlook for you..and you again achieve a happy state of mind.
I have seen in my husband and son that level of depression when making the decision to get out of bed is major.....the mind can be a place of personal hell. As you said the side effects are minor in comparison to what further deterioration can bring about..
I am thinking of you and your journey, please keep us all posted on your treatment and recovery.
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901137 tn?1267626189
My first post to this tread stated that I was experiencing treatment resistant moderate depression. The doctor now sees that this is treatment resistant SEVERE depression.

He told me it was highly unusal for someone to be able carry on daily activities with this degree of depression. I could only reply I'm very fortunate as it takes everything I have to simply get out of bed each day.

I need to continue to work my way through this.
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901137 tn?1267626189
I have posted to my journal but have not followed up here. My doctor let me know that we have run the table on SSRI class medications. The next option is MAOI meds or electroconvulsive therapy (ECT). We discussed both and he asked me to think about it. He did prefer ECT but was very clear that he would support whatever I was most comfortable with.

I've decided to begin the process for ECT. I can always back out as I learn more and try the other meds.

Things are continuing to deteriorate for me and I am more concerned about what that might mean than I am about possible side effects of either option.

I have to think there is an answer for all of this.

My best to all...

Mike
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901137 tn?1267626189
During the visit with my doctor this morning I was very clear and specific about what I have been experiencing. I’ll spare you the details but he has modified my medication and will see me in a couple of weeks to see if that helps. If there is no improvement we’ll move on to the next level (undefined).

I raised the issue of talk therapy although each of our sessions is a form of that. We’re both going to give it some thought and discuss it later.

A doctor can only help someone if he knows exactly what the issues are and the discussions we have had here helped me to accomplish that.

I can’t say I’m confident I will find an answer. For now, I simply want to retain the motivation to continue the search..

Thanks to all…
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874521 tn?1424116797
ur handling your situation correctly, ur reaching out and thats a very good start!!
I hope your doctors appt. proved successful for you...don't be discouraged if it wasn't...sometimes it will take many appts. and many trials on a variety of meds to finally reach the peace ur searching for.....just remember it can b there for you just hang in and never give up trying!!!
We r always here for you Mike and u can handle more than u give yourself credit for.
U r a good person
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901137 tn?1267626189
If you have read my journal you know that things became a bit worse last night. It has pretty much continued throughout today.

I understand what everyone  says about talking with someone about what is going on with me. It’s true what Opus said about public masks. I have been wearing mine so long I have in a sense lost touch with who I am.

LeftCoastChick’s list of behaviors all hit the mark to one degree or another with the exception of being financially irresponsible. I have brought them all up to my doc at one time or another.

I have a lot of things going through my head right now as I think about the appointment with my doc tomorrow.  It I could summarize it all in to one statement it would be:

“Please make it stop before I simply can’t handle it anymore”
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901137 tn?1267626189
I figured out the problem. The system is fine apparently it's me that's not working so well. (blush)
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901137 tn?1267626189
I am unable to get to posts made after LeftCoastChick's on May 25, 2009 04:13PM. I only can see the first page and cannot access pages after that.
Any ideas to resolve this?
Mike
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Avatar universal
I can completely understand that. When I was diagnosed, (not saying you are), but it was overwhelming.

The new DSM is coming out shortly and they are adding more types of Bipolar, like Bipolar Spectrum, Bipolar NOS, Rapid cycling and mixed states, which may turn out to be BP3 and BP4.

When you see a pdoc, before you go, write down all the odd things, or just things you do, it will make it easier to diagnose whatever you have easier.

Hoarding or being messy or the flip side, obessively clean.
Getting irritated by loud noises like ambulances.
People breaking rules, for me it's backpackers who don't take off their packs and wack people with them. They are supposed to take them off.  Or when folks get on busses without paying for the ticket and I always do!
Crowds make you uncomfortable, like going to malls. I get headaches.
Rapid thinking.(ADD like symptoms)
Forgetfullness ( gets worse with depression)
Avoid social activities
Sleeping very little, but feeling extremely energetic
feelings of total disinhibition and exhilaration
financially irresponsible (racking up credit cards or gambling)

So these are just a few, everyone's symptoms are different.

Cognitive Behaviour Therapy can help you stop your negative thinking before you snowball. It doesn't always work, I still have my days, but for me, it makes me stop and think before I do something.

So this is just a bit of food for thought.  For me having the diagnosis finally has made my life make sense if that's the least it's done. I'm on 5 meds, my depression is still really hard to treat, 3 of my meds are for depression, one for insomnia, one for my hypomania.
I rarely have to take Ativan, but I take that more for restless legs, I had a mild case before I started on the meds, but got exasperated by one or more of the meds, so I take an ativan at night, the meds for RLS are nasty - so no thanks! I know of a couple of people who are only on 2, I"m slightly jealous, but I knw each person's journey is different.
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901137 tn?1267626189
I have heard what each you have said. It's a little overwhelming to see how your messages are so personal. It's been a while since i have experienced people reaching in.

I need a bit of time to gather my thoughts as I'm having a bit of difficulty getting the words together.

I'll wrap myself with your words as I go through my day and try to make sense of it all.

Later....

Mike

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Avatar universal
Hi Mike,

I was quite worried my saying to you you must start talking would turn you the other way. I'm very glad you have at least not rejected it and also that all others have said the same thing essentially.

Why do you think that is Mike? I can tell you but you need to understand what we are all saying. That is simply that meds can help us battle through and they do relieve symptoms but they never cure causes.

Only you can do that and only through talking to an unbiased professional mate.

I hated the thought of talking about me before my world fell on me. I haven't stopped talking since as I know the danger of bottling it up, putting it to one side and hiding it. I did it big time for about 25 years, childhood training caused that as it is for you.

I have to say when I first started talking I too didn't think it was helping much if at all. You see I expected to have a few sessions, suddenly have a trauma revealed and confront it and be OK. Never happened as that is a media garbage image.

How it works is rather that you go through all you can rmember that is around the issues, talk it rhough, consider the effects on you and who did what and why. You then look at how you can deal with what happened and how you can go forward as you can't change the past, you have to live with it. If you keep hiding it every single day it will get worse and affect your actions and all every day.

Aren't you sick of that? Start talking Mike, here if you want first as it's quite safe here. Try a little bit at a time and see how people respond to you. If you can do it here then you can do it with a psych etc.

I also have to say I thought CBT was pure rubbish. I did the courses twice. One in group and one on one sessions as well. The sessions were all great and I understood it easily, as you will, but I couldn't practice it.

Those with deep depression find it almost impossible to practice CBT according to docs, not psychs as they say we can all do it. It's not easy to do.

I found though that after a year or two I was actually doing it myself without thought. I had learnt the theory and wanted it toi work so much but seemingly couldn't do it on my own. Now I can.

I think it's as simple as people like me, and you, are so damned stubborn about what we think we know. I rejected CBT as I couldn't do it immediately. But today it is a thing I do each time I lie down, catch my thoughts and stop them and replace them with different thoughts that are not the old negative soundtrack I listened to for ever.

Do you follow what I'm saying? Don't expect miracles but don't penalise yourself by saying it won't work. It may not Mike, nothings assured. But if you don't try it certainly won't work will it?

There is some talk here about BP. I didn't see anything you wrote indicating BP but mood stabilisers are not just prescribed for BP Mike.

Lithioum in particular is frequently prescribed for bad depressions simply to try and stabilise our moods. So you don't need to be bp to take it.

I note you say none of your family worry about you. May I say that is absolute tripe Mike. It's what you would like to think but of course they worry about you. What they do is what you want them to do. Pretend everything is OK. That does not help them at all nor does it help you.

How do I know that? It's what I did before the crash(es) I had. I wouldn't talk and wouldn't take advice and wouldn't even consider someone saying depression. I spurned all of that. As I was right, NOT.
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874521 tn?1424116797
Mike....all the medication and symtom information u have been given are all very 'individual' opinions...but the bottom line everyone is urging is for u to see someone TRAINED that u feel comfortable opening up too.
Interesting to me is u keep referring to your wife and sons as well adjusted happy people yet you haven't opened up to them and they need u to do this...could b one of your sons is also suffering but afraid likewise to speak of it as his dad and all the family appear to be 'well adjusted happy people'.....they too may also be wearing their masks around u...just a thought.
Get some help please before your depression gets to the stage that you believe your 'happy' family would be better off without you....this is all vry typical of the 'happy...NORMAL' family, and individuals that HIDE their true unhappiness within themselves so as not to disrupt the harmony.
I can bet You feel that ur the only abnormal one and r ashamed.to have your family view you in a less than PERFECT way, Ru also a perfectionist Mike???...please get help Mike.
Pat
'
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Avatar universal
MIke you also need to look into what is called Bi-polor NOS (Not Otherwise Specified)

My Psychiatrist is a very respected member of the Center for Psychopharmocology. He has told me the very recient finding suggest that many people with "Treatment Resistant Depression" have simply been mis-diagnosed and they may have some components of Bi-polor dissorder.

We are all familiar with Bi-polor 1 & 2 but my P-doc is working with many other top Psychiatrists in his feild that are no finding that there may be different types of Bi-polor that require specific medication combinations to treat.

Have you ever tried an SNRI, Lamictal and Lithium combination?

My P-doc told me that in just a year or two there will be two more classes of Bi-polor dissorder that will be added as Bi-polor 3 & 4. These NOS types of depression are often mis-diagnosed.
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Avatar universal
It is really important to talk about what you are going through. Talk therapy may not "cure" you alone, but talking to somebody (anybody) will help. Facing your demons is really difficult, and at times painful, but it is essential. No amount of medication can make "everything go away." However, there are a lot of different medications that can be used to make a cocktail that may work for you. Don't give up hope in regard to meds. You may want to consider speaking to a good psychopharmacologist. MAOIs are usually used as one of the last resorts (second to ECT) because they have many side-effects and potentially dangerous interactions with certain foods and medicines.    
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874521 tn?1424116797
yes we all have our public masks don't we...we seldom allow others to see inside.
I agree with whodunit.u need to open some of those 'boxes' they r subconsiously eating at u!!
My husband was much like u, he functioned at work and at home and he did a good job with his masks.....until the world fell in on him one day and he shot himself!
U do need to talk openly with someone u can trust and be real!!
take care
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901137 tn?1267626189
I appreciate your thoughts and those of the others who have reached out. It’s helpful to hear how others in similar situations have faced the challenges.

I was on Abilify for a while but it had no effect. Although I have gone through many different medications without success I have not experienced side-effects. Hopefully, that will continue.

I need to better educate myself on what being bi-polar means. It has never come up in discussions with my doctor. I’m not sure if it is important as whatever I have is called, it’s not good.

My short term goal is to hang on until the 27th, my next appointment.

Mike

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909257 tn?1242668182
Mike I agree with the others and would like to say that i  am newly diag w/bipolar disorder. In the past year I was depressed and anxious on and off. I became so depressed I did not want to get out of bed. I tried many anti-depressants and they either worked for a while then stopped or made me have bad side effects. I was then put on Pristiq and became so nervous and panicky. The dr then took me off that and put me on Lamictal in a low dose. It has not even been a week and I feel so much better. I have pain issues also, but I currently take Trazadone 200mg. and Lamictal 50 mg. both at bedtime. I'm not saying I'm cured yet but I definately feel a difference with the Lamictal (mood stabilizer). Like the commercial for Abilify (mood stabilizer) saying if you're still depressed add Abilify.You may want to take this up with Psych.
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901137 tn?1267626189
LCC,

I will check out the CBT. I have heard of it but can’t recall exactly what it entails. Thanks for the heads up on the Mood Stabilizers. I will also look into those. My doctor has not mentioned the MAOI class of drugs, its more speculation on my part.

Interestingly enough I would tell someone else to not rely on meds alone. It just feel sooo different when it concerns me.

Perhaps the fact that I seem to be struggling on a daily basis will be what I need to at least look into it.

Take care and thanks!

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Avatar universal
You might want to look into seeing someone who specifically deals with Cognitive Behaviour Therapy - I hasn't been around more then I'm guessing 20yrs and has been proven very beneficial alongside meds.

Before you go to the MAOI's, which my pdoc said were "dirty" drugs with too many side effects and restrictions. Inquire about Mood Stabilizers, like Lamictal and Lithium, both which have been around 20+ yrs with very good stats, there are other meds in that category as well. As whodunit said, you have to be willing to help yourself first, take some chances, sitting on your hands and expects meds to cure you, will fail.  You have to be agressive with your wellness.
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901137 tn?1267626189
I tried talk therapy briefly in the early 80’s without success. It might have been me; it might have been the therapist but it didn’t seem to have a direction to it. I know that is not a predictor of what could happen now.

I am not embarrassed about the past. Here’s the deal…..

The pain I feel emanates from what people did and didn’t do over the years and is beyond my ability to describe. The only way I’ve been able to get by is to put it away along with a part of myself. Sure it has been tough but I get satisfaction from having a wife that is happy and three grown boys who turned out great along with four grandchildren.  None of them worry about me and all seem settled in their lives.

I don’t mean to be over dramatic, nor am I a martyr and certainly don’t want anyone to feel sympathy for the situation. We all do what need to do to get by. My real goal is keep things from falling apart and it’s good for everyone that so far I have found a way to do that.

I appreciate your advice and know there is truth in what you said. I have not dismissed it and will give it serious consideration as I go along.

Mike.







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Avatar universal
Hey Mike,

Are you serious about getting your mental health back? If you refuse to try what is mainstream, normal treatment then I despair for you.

Talk therapy is by far the best method of dealing with depression and does actually change and cure it. Meds do not, ever, cure depression. Are you aware of that?

Meds are designed to relieve symptoms, not remove them. They can't, as much of our problem is environmental. That is we may have an abusive partner or workplace or similar day to day confrontations that cannot be resolved by talking meds. Can you not see that?

You dismiss talk therapy by saying things were a "bit goofy" when you were young and don't want to go there.

The reason you don't want to go there? In my opinion? Simple. That's where the problem is.

Make a choice. Keep your mental problem or allow real treatments to at least try and assist. If you choose to hide because it's hard or embarrassing etc then your future is already set Mike. Face the fact. Youir comments above are very clear.

Help yourself Mike, forget everyone else for a change, you are the one that matters mate.
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