outcome

[molayne]

hi! i have been under treatment for depression for about a year, and was actually severly depressed for about a year before i was diagnosed. i have been on a multitude of antidepressants, and i have yet to respond to anything. i was so bad that i was in the hospital for a month, and the only thing that helped was ect. i had 6 treatments and the dr. stopped because of my confusion and memory loss. i was severly underweight due to the loss of appetite, and did gain some weight after the ect, but i am beginning to slip back and i am afraid. i saw my dr. and he is recommending more ect, and i really dont want to agree but i feel, as does the dr that its the only alternative. i am frequently having suicidal thoughts, at this point i think i am afraid that this is as good as its going to get and i cant face a future in this state. i understand that the usual course of treatment consists of 10, so that only leaves room for 4 more. while the ect did help some, i am still very depressed and i cant see 4 more treatments doing much more than the 6 did, which leaves me in a permanent state of depression. i asked my dr what happened if the ect didnt work, and he replied that he didnt know. i needed some reassurance and he couldnt give me any. i am at the end of my rope, and my hands are slipping. can you offer any suggestions? i am afraid i cant face many more tomorrows if some light doesnt appear somewhere soon. thanks  scared

[HFHS MD - RG]

The usual course of 10 treatments are the initial treatment for ECT. After the 10 treatments, a maintenance treatment is advcated (the frequency is decided upon your clinical response and presentation).

Other management strategies include polypharmacy meaning using more than 1 psychiatric medication including mood stabilitzers like Lithium or Depakote and most recently neuroleptics like Risperdal or Zyprexa alongside with an antidepressants.

Literature also shows the use of the above treatments with psychotherapy proves to have better results.

Do not lose hope. Oftentimes, a thorough consideration is made for treatment-resistant depression.

I recommend that you discuss these options with your psychiatrist.

[NRO-Sx]

Dear Terrified:
I can sympathise with how you must feel about the idea that you are gradually running out of options re your depression.  However, ect is NOT the end of the line treatment ... i.e. even if 10 sessions of ect don't work there are a vast variety of other alternatives, some old and some new.  For example, there are a variety of drug combinations that you can still try (e.g. TCA's plus SSRI's) and different types of psychotherapy (e.g. CBT, psychoanalytic ...).  Clinical trials are underway using transcranial magnetic stimulation (TMS) for the treatment of depression, and there is a lot of research these days on the role of the immune system (e.g. hypersecretion of cytokines etc) in so-called "treatment resistant" major depression.  So please, please don't give up thinking that there will be a happy ending to your story ... one day you'll look back on these times and be so glad you had just "hung in there".  You deserve to feel good soon, and if you don't give up hope you will ... guaranteed.
Best wishes,
NRO-Sx

[terrified]

thanks for your optimistic words, but i cant seem to find the will to be optimistic any more. i was once a strong, vital, healthy, happy person and i feel as if that person is dead. i dont recognize the person in the mirror any more. i cant find light in this deep hole or get a hold of anything to help myself out. i am no good to my family or myself as i am now and i want the worry and pain to end for all our sakes. i have been in therapy for a year, i have tried group therapy, i have tried ssri's and combo drugs. i feel very guilty that i am not in control, i cant pull myself back up. i have never been sick before, and i cant understand where this came from. i understand that its a clinical condition, but i feel as though there is something i am not doing, but try as i may, i cant make myself feel alive again. i do appreciate your kindnedd and i too, hope that something becones available SOON that may offer some hope. i am sure i am not the only person that has felt trapped in this world, and if you havent been here, it would be hard to understand. the doc keeps telling me i am so much better that i was, unfortunately, i cant remember. all i know is what i feel now.  terrified

[NRO-Sx]

Dear Terrified:
Even though you think you have lost all hope, you have been doing many things to help yourself:  you have admitted that you are clinically depressed and that for now you're not totally in control (feeling guilty is about your lack of control is understandable, but realise that the guilty feelings are SYMPTOMS of depression and that there is NOTHING you are "guilty" of), you have sought psychotherapy and group therapy, you have tried medications, and by posting on this forum, it's clear to me that you have not given up hope.  I think it might be a good idea to talk to your doctor about volunteering to be a part of a clinical trial for depression (inevitably the therapeutic benefits gained in clinical trials are greater than those gained outside of the structured environment of a clinical trial).  Finally, even if nothing seems to be working, TIME IS!  Clinical depression, like any other non-terminal disease takes time to run its course (sometimes up to 2 years) ... it is NOT a chronic state.  Because you have been fighting it for so long, the end is nearer and nearer every day.  Please Terrified ... just hang in there -- you'll thank yourself later I promise ;-)
Cheers!
NRO-Sx

[I get scared to, this is what I have don]

Sometimes the despair seems unbeatable.  I get desperate and critically frustrated.  I get to a place where I just couldn't do it anymore.  If I could only get a holiday from it, just one day, please.  The lose of control is tough too.  That may be a guy thing.

PLEASE CALL SOMEONE RIGHT NOW.  Please.  If you don't have friends and family you think you can talk to, call a help line in your area (find out the numbers now and put them on a piece of paper by the telephone.  A good website for support is

http://www.metanoia.org/suicide/index.html

&

alt.support.depression

Does your family know?  Close friends?  Have a list of "good phone numbers" by the phone.  People that you know are supportive of you.  I could not have survived without my families. (My mom & dad, Wife, child, her parents)  They don't care about anything but my well being.  I get unconditional support.  

No two cases are the same, but I do understand your pain.  Have you tried other medications.  Prozac, zoloft, elavil (also helps you sleep and is non-habit forming) Trazodone.  I am on a combination zoloft, elavil, and large doses of morphine.  ( I also have horrible pain that causes me to throw up, and causes major cramping as I clench against attacks.  It also effects balance. I've had two  long flights off of a longer set of stairs, as well as two tub tumbles.)

I was at a place were I was flipping a coin almost every night.  Oddly I didn't lose a single toss in two weeks.  I stopped after prozac, my first Anti-Dep. medication.  I have good days and bad, I haven't worked for months and I really miss it.  

It is for real, you are not crazy, you are not bad, and you can make it.  

The depression is getting better, slowly.  I do have backward slides.  Often I get scared then, I feel like I'm never going get out I get panicky.  

I have severe brain abnormalities which cause horrific pain, blackouts and getting lost coming home from Starbucks (two blocks).  It is getting worse, and surgery or indefinite hospitalization (because I am maxed out on the morphine, and the pain is catching up.  The next move is in the hospital for IV drugs.  I can't stand the hospital) are on the horizon.

But, in spite of that, I am being to feel better (comes and goes)

Hang on, Hang on, one more day...........

[terrified]

thank you for your reply. i wonder what you mean when you say "a thorough consideration is made on resistant depression". i am holding, but these thoughts are ever present and i am tired of fighting. this has to have an end sometime and if this is the life that lay ahead, i don't want it. this isn't living, this is punishment for all who are involved. it isn't what its done to me, its what its done to those around me. i keep hearing " hold on" and don't give up hope" hope is a rare comidity and there comes a time when you know giving up isn't the worst thing that could happen. i just dont want to do this any more. life was very good before this hit, and i guess i am not willing to accept so much less. everyone deserves to LIVE, and i have, and i am not afraid any more. i know that the decision is mine and mine alone, and that gives me a certain freedom from the darkness, a certain amount of control. it feels good to realize that i am in control after all.  not so terrified anymore