I'm looking at my options for treatment resistant MDD, ECT, TMS, Spravato, Psilocybin, whatever might relieve the depression, anxiety and PTSD that I've struggled with for more than 25 years. The problem with TMS is the hour drive each way, and even more, having to stop Wellbutrin and Klonopin, both of which I've taken for 20 years. I'm afraid that stopping (tapering) them will put me back in the suicidal, deeply depressed place I was in when I started them. ECT is the definitive treatment, but my wife objects strongly to it. She only sees the possible negatives, and it makes me feel like my mental issues aren't important enough to risk any possible side effects. The ECT is only a 30 minute drive from home, and only 6-12 treatments, as opposed to 30 TMS treatments an hour from home.

I reacted badly to Ketamine, given to me post surgery last year, and my wife thinks that Spravato would cause the same dissociation, even though the dosage is a fraction of the Ketamine pain medication I took.

At this point, it seems that my only option is to trudge on. I'm just tired. At this point, TMS is too much of a commitment, Spravato may be contraindicated because of my reaction to high dose Ketamine, and Psilocybin is still in the experimental stage. Unless there are other treatments for treatment resistant MDD, that leaves ECT as my best option. I'm not afraid of the possible side effects, but I have to decide if I want to do it in spite of my wife's objections.

It's hard to make these kinds of decisions when a person is truly depressed. But the decision has to be mine, hard as it is. I know I can't be forced to make a decision that I'm not comfortable with, or be told a treatment I select is out of the question. At 75, and being of sound mind, it's still a challenge.

Jim