Treatment resistant depression help.

@melbourneausssie69
I also have ptsd, panic attacks and anxiety/depression but have not had a transplant. I do have chronic pain and had several spine surgeries (I’m 55). It really does sound like you may benefit from an antidepressant to help you. I am dealing with major depression that has been treatment resistant. I take 450mg Wellbutrin (generic is bupropion and it was recently increased from 300 mg to 450 mg) but my mood is flat and I’m still depressed, cry at times, and don’t want to live some days. I am definitely not my former self and feel like someone hijacked my brain and former life. Doctors need to adjust medication to find the right mix and balance for each person. When I had panic attacks while pregnant, Zoloft/sertraline seemed to help me. I may ask my psychiatrist to put me back on abilify/aripiprazole to augment my Wellbutrin since my depression is not improving.

Don’t give up trying to get the right medication to help you manage your symptoms and improve your quality of life. You were given a 2nd chance for a reason and valued and loved. My teen son needs me and I am a single parent with no family so I need to keep trying for him. Praying for you to get the help you need and deserve.

@melbourneaussie69
See my previous post.

G'day.

Sorry to hear of your troubles. I am curious as to the specifics of onset of your PTSD. Did you suffer any rejection effects during your procedure/recovery? What seems to disturb you most about your transplant experience? I haven't had a lung transplant, so am naive about the process and the complexities of living with one.
The blurb I read online about interactions between Tacrolimus and cannabinoids wasn't very instructive. Did a doctor recommend you try cannabis?

Trust me when I say this, I have had multiple Psychiatrists, Psychologists and my GP of 14 years and tried everything. They cause all the rare effects on me such as violent tendencies, suicidal ideations to the point I have had a loaded gun to my head. I turned to illegal drugs and benefitted from amphetamines and MDMA but that is no way to live. The main problem I face is each time I trial a new one and go off the rails it takes 8 weeks to wean off them and you feel terrible.

The main source of my PTSD was the 5 weeks I spent intubated with ketamine causes vivid dreams with death being the overall theme. Upon coming out of the induced coma I awoke unable to move due to muscle weakness, this was during COVID and I was not allowed any visitors. The oxygen supply from the hospital wall was not sufficient, even when turned up to maximum. This meant any time I exerted myself I could not breath as my lung capacity was 20% and I would have a panic attack. I was placed on high flow eventually. Minor infections caused my saturation to drop to 61% until eventually I was faced with that talk the doctor initiates about getting your affairs in order. I am married with five kids, three from a previous marriage where my first wife died of cancer.
I initiated the medicinal cannabis idea, the lung clinic was dead against it but eventually approved it. The cannabis competes for an enzyme in the liver to break it down that is also used by Tacrolimus. This can lead to high levels of Tacrolimus which is not good. I counter this by leaving a 5 hour gap between the taking of each. This seems to have worked in keeping down the Tacrolimus level to within range. The cannabis has helped more than any of the anti-depressants and I can stop without any weaning process.
I know I should be elated and thankful for getting a second chance but the cocktail of medication and the constant rotation of the public hospital system effects the continuance of care with a different doctor each appointment. I raised my concern as to the average life span of a lung transplant patient which is 50% of recipients die within 5 years and was told "Well it is a palliative procedure". Losing my first wife, being a prison officer and experiencing a riot and then coming close to dying are most probably contributing factors in my PTSD and Panic Disorder.

Thank you for your suggestions I will mention the medication you are taking, but I am weary of anything that takes 8 weeks to work and then 8 weeks to get off.

@melbourneaussie69
I noticed some benefit from both Wellbutrin/bupropion and Abilify/aripiprazole in about 2 weeks. Doctors in the states are starting to augment antidepressants with antipsychotics for those resistant to treatment and it may take a couple trials with the right mix and dosage. You shouldn’t need to wait more than 4 weeks to determine if a medication. The sooner you can tell if it helps or causes bad side effects, the sooner and easier weaning off should be. I tried fluoxetine (generic for Prozac) and I was okay 20 mg but when they increased to 40 mg, I started to get brain zaps so I started to wean myself off it.

I am so sorry for all you have experienced. You and your family have been through a lot and I pray that you get the best care possible within the socialized medical system. It must be hard to get timely, consistent, and quality care.

I don’t blame you for trying things on your own. I have often thought to myself that when someone is dealing with chronic pain and major depression that is hard to treat and they suffer for a long period, I wouldn’t be surprised that they would turn to anything they thought might help them endure each day. I am desperate for relief and it is hard to endure all of the medication and treatment trials but I keep having daily hope that something will work/help.

Wow!!!
You've been through the wringer, alright!
I'm not sure I'd have the constitution to put myself through what you're enduring. You're very brave. What necessitated your transplant operation?

I am so sorry to hear all that you have been through and PTSD sounds like the correct diagnosis if these experiences continue to impact your daily life. Having a chronic illness for which there is no treatment yet and significant chronic pain due to spinal issues and a constant migraine for the last 25 years, I understand the depression and anxiety that goes along with those things, but I can't imagine what it must be like for you. You also clearly have an extremely stressful job as a corrections officer. I am a psychotherapist (Licensed Independent Social Worker in Iowa) and have worked with individuals with similar situations--just not all at once with a single person--so this is tricky. You are most definitely not alone in the suicidal thinking. I want to make sure that you have a safety plan so you know what to do/who to call if you find yourself creeping up to the edge of the cliff of making an attempt. It also sounds like you have a lot to live for, especially your children. Please remember that there is no right or wrong way to feel after a transplant, please avoiding "should-ing" all over yourself. It is not helpful, it is not useful and it does not help people heal. One thing to remember is that you can't believe everything you think, sometimes our minds lie to us and feed us narratives that are false. Be kind to yourself, notice if you are talking/thinking to yourself the same way you might talk to someone you care about. Also notice if you would allow others to talk to you the way you do to yourself...if the answer is no, then think about why you are allowing yourself to do so. Addressing the issue of treatment resistant depression, have you considered ECT or TMS? Maybe look into those as possible non-medicinal treatments. ECT's aren't what they used to be, so keep an open mind. I pray for your healing, your health and mental health and your family.

First you have been through a traumatic health experience so try to be kind to yourself. I have tried at least 40 medications for depression along with EMDR, ECT, ketamine treatments with little to no change. Recently I have tried mushrooms that I have found somewhat helpful in keeping me calm where I can function with life and still process feelings.