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901137 tn?1267629789

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

35 Responses
Avatar universal
have you exhasted all pharmological treatment options including augmentation regimes with differing courses of anti-depressants? what about psychological therapy such as CBT in order to change perhaps how you see yourself and experience the world around you. Perhaps you could access this through ypur health centre as  you may not need to be referred to specialist services. Have you considered being referred to specialist services if you continue to still feel terrible, as they would perhaps have more knowledge and be able to adopt a multi-faceted approach incorporating additional support and approaches to treat your difficulties. Everyone is unique of course as personally i find exercise and being considerate about alcohol and having "me" time, alongside my augmented regime. There are alot of options out there so don't give up hope to feel better about yourself and your world around you.

585414 tn?1288944902
"Depression Central" is a good website for all available options as regards medication. You could speak to your psychiatrist about what might help as regards available options and you could inform yourself as well. I would agree with the other post as well.
Avatar universal
Sorry Mike but I do not like the sound of your doctor.

Moderate depression is highly treatable so if the doc told you it's both moderate and treatment resistant I think he's a fool. My opinion.

That aside I too have long been in the treatment resistant category. Which makes me ask "So why does the doc insist on prescribing me meds and continuing to see me"?

If it's treatment resistant then treatment won't help, right?

The reality is I have come from totally suicidal 10 years ago to today where I am basically at peace. Haven't worked all that time for obvious reasons (imagine a help desk with a suicidal person answering the phone!!!!) but I no longer feel the pain of the pit and haven't been down there since way back then. I don't feel fear, anxiety and paranoia any more. Odd ocasions, sure, we all do, but it's gone from being there 24/7 for nearly a decade.

How did I get through that? Treatment of course. So it is not treatment resistant at all. I'm just one of so many who the docs feel frustrated at not being able to pull back a curtain and pronounce "Voila, all cured".

Won't happen for most of us. And I'll tell you why.

My life was a mess but I did Ok till 48 when work issue flattened me. Took all my faith in society, law, government, people and all that away. I could never trust someone outside my family again, and only a few of them.

So life changed for me but even though I've done CBT and finally got it going I will never be able to change my perspective back to the open, trusting approach I had.

You follow? I finally had enough of the world and it's nasty ways and can never let that back into my life. I still live in that world but I limit my interaction as needed.

I was able to not work financially so I could manage OK although I'd rather have gone on in my career as I was just getting where I wanted to be.

You may not be able to make my choices but the key is you can't work, right?

It sounds very much to me like you need to see a psycholopgist, someone who specialises in depression, not a motivational type.  The doc has done what for you so far? Is it a GP or a psychiatrist. If a GP then move up to a psychiatrist.
Avatar universal
To be honest, if you have moderate depression, then you wouldn't be treatment resistent or what is called refractory depression. There are a multitude of meds out of the Anti-depressant category that work even better then the SSRI classes. When I hear that someone has tried "all" the meds, that just simply isn't the truth. Is your doctor your psychiatrist? If s/he isn't you need to see a psychiatrist, they are experts in psychopharmaceuticals. I was diagnosed with dysthemia, which is moderate but able to function depression years back, but then was diagnosed Bipolar - many folks are misdiagnosed with moderate depression when it's actually bipolar. I'm on way better meds that work amazingly well. So I would get a shrink or a second opinion
901137 tn?1267629789
Thanks to all of you for your responses.  Here’s is a little more info. I’m 59, married 37 years, 3 grown boys with four grandchildren. I am currently and have been working with a psychiatrist who has an excellent reputation. I have been with him for a number of years. I exercise regularly and stopped drinking five years ago. Over the years we have gone through a load of different meds. Right now I take 450mg Bupropion and 300 mg Effexor daily.

In 2007 I had a comprehensive neuropsychological evaluation. The neuropsychologist findings indicated I scored in the severe range of depression and that I had many signs of an endogenous depression correlated with a dysthymic disorder. My doctor did not agree with the “severe” designation in light of my ability to function on a day to day basis.

The people in my life have no idea there is a problem. In fact, unless I mention it to my wife she thinks everything is fine. No one knows what a struggle it is to get through the day. Truth be known I can’t recall ever being at peace with myself.

Having said all this I am grateful that ours boy turned out great and I have been able to perform well enough at work to have maintained my employment at the same place for nearly 30 years. Given these things I often feel I need to simply “get over it’ and stop whining.

I am coming to a point where I need to accept that things are what they are.

Again, thanks so much for your thoughtful notes.


Mike



Avatar universal
hey Mike,

Your stats sound much like mine. Very similar, age, family, depression, the lot. And Effexor 300 mgs too. Are you me? Joking but it's a touch eerie.

I'm glad you clarified the diagnosis as I strongly believe your doc is wrong. The test is accurate and gives a better picture. Often if we've seen a doc for some years, like I have too, we become friendly and tend to be very relaxed and even joking with them. I do every time, I llok forward to that short meeting as I know it'll have some laughs in it.

This can of course give the doc a different impression of us than reality at home. Does your doc ever ask your partner in so she can give her thoughts? Mine sees both of us every now and again as a cross check which I don't mind a bit.

I saw mine today actually and we discussed this diagnosis "Treatment resistant depression". We agreed it was a meaningful term for docs but quite misleading for us. He said he would raise it in the many forums he is part of as a professional psychiatrist.

He explained that the diagnosis can be made when a patient fails to fully respond to 3 separate recognised meds (for depression) each taken for a minimum of 12 weeks. OK? So that tells us what we need to know. It's just a definition they use but I recall when I first got told that my thoughts were that I was finished, untreatable.

Jargon is often damaging. Like we also discussed the terms used for suicide in doc speak. He said these days it's "completed suicide attempt" rather than what it used to be "Succesful suicide attempt". You see the difference?

It's just words and the key thing is that you are happy with that doc. Are you convinced he has given you the correct diagnosis and has always had an option for you when a med petered out etc? If so then he's good. If not, maybe time for another. Having a good reputation does not mean a doc will suit me, or you but it sounds like you are quite happy with him, so that's OK.

If you are still working mate you must be doing something right. I couldn't possibly. Then or now. I'd attack someone I'm sure. For not very much too I would guess. Anger simmers close to the top for me.

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