@beachesanddreams I've been living with psoriasis since the age of 11, and over time, psoriatic arthritis developed as well—bringing with it a deep, persistent depression. Despite being on SSRIs for eight years, they had no noticeable effect. I eventually stopped taking them, and nothing changed, which confirmed what I had long suspected: the root cause might lie elsewhere.

For the psoriasis, I used topical corticosteroids, which provided only marginal relief. Years later, I was diagnosed with midbrain inflammation—likely caused by a viral or bacterial infection. This inflammation may be the underlying cause of the depression, with inflammatory cytokines believed to be the main drivers of the process.

In 2008, an MRI revealed a Chiari malformation. Although I underwent decompression surgery, it did not lead to any significant improvement in symptoms.

This presents a complex medical challenge, as there are very few treatments that effectively target brain inflammation. I experienced brief relief with methotrexate (MTX), but the side effects were substantial. As with many treatments, responses vary widely depending on the individual and the presence of other comorbidities.

Currently, I'm managing fairly well while taking cetirizine (an antihistamine) at night, which helps keep cytokines partially in check. However, depression resurfaced after I contracted COVID-19—possibly due to renewed brain inflammation.
Keep advocating for yourself, and if necessary, don’t hesitate to change doctors.

I found a very interesting explanation for depression and inflammation, you may like to review: https://www.youtube.com/watch