Treatment Resistant Depression: What can I do?

I have been battling depression for many years, and insomnia for a long time. I tried a sleep study. All I was told that I have bad insomnia and restless leg syndrome. A lot of lab work. I'm not anemic or have a vitamin deficiency. GeneSight test to show which meds would be best, okay, and not a good fit for me. TMS last year. Walking and going on different diets. Last month I tried Spravato. It seems like it's getting better. Sometimes I feel nauseous and throw up. If I planned better, I don't throw up.
In a few months, I'll be working with my health coach again that does functional medicine.

@vijay26
Your dr. might be able to get you free samples from the pharma rep. Many drug companies have a low cost plan as well that you can apply for. I did this for a few of my patients and it was a real help!

@myacct123 —as per above, ketamine can be very helpful for some. Unfortunately, it didn’t work for me. I pretty much tried everything with no relief.
Then in year 15, I ran across an article about this new treatment which was experimental at Stanford. It sounded as if it might work. This was in 2022. I called and got an appt. and flew to California for this treatment called SAINT (Stanford Accelerated Intermittent Neuromodular Therapy) which is a variation on TMS (trans magnetic stimulation).
You might try regular TMS first if you haven’t. It might work for you. It didn’t for me.
SAINT is 5-10 days of back to back 15 min. TMS treatments. There are 10 treatments given each day. Because my depression had been so lengthy and severe, the 10 days were recommended. I was cured!!
It cost $26,500. Insurance didn’t cover it at that point.

But don’t panic! The treatment now runs about $6500 and most insurance (Medicare, too) covers at least part of it. Also, you don’t have to go to California. Since it is a now accepted treatment, there are centers all over the country.

I have already asked my Psychiatrist to get me free samples of antidepressant medication. But, he said that he didn't have any source of Pharmaceuticals giving him any samples for my depression.
Thank you.
VJ

Dear @myacct123 ,
I am 72 years old, was diagnosed with bipolar depression in my forties, and spent decades battling with crippling TRD, in and out of psychiatric institutions while trying to raise a family of 4 children. I empathise with what you are going through - severe depression is almost impossible to describe to someone who has not experienced it. It poisons your whole life. Over the past few decades I have been on innumerable medication regimes - some seemed to work for a while, then 'pooped out', and I had to start all over again trying different medications and combinations. At last I seem to have hit upon a combination that works for me, and have been stable and well for years. Don't give up! There are endless possibilities of medications and combinations out there, and you will find something that works for you. You have to have patience - I know it is hard and discouraging to start something new and have to wait for weeks to find out whether it helps, but do not give up hope. Apart from medication, my psychiatrist of 20 years recommends two things to deal with depression; a regular sleep routine (I know it is easy to say that!) and a regular daily routine. Getting up at the same time every day, having regular routines and activities, and above all trying to engage despite yourself. You may have to force yourself into a routine, but this helps with the circadian rhythm; just lying in bed will hinder your recovery. Be careful of supplements. I was taking regular multi-vitamins, and started to get numbness and weaness in my limbs, and had several falls. A comprehensive blood test showed that I had 600 TIMES the normal level of Viamin B6 in my body! Don't jump onto the latest bandwagon on the internet, discuss other options with your doctor before you start anything. I feel for you, and am thinking of you here in far-away Australia.

Found a therapist that prescribed Alpha Stim device. I bought it for anxiety, but it also works for insomnia and depression. Also recently started neurofeedback.
Please be careful of meds, not all are perfect, some will force you to find new drugs. Before you realize, you will not remember who the original “you” was.

@joyann80
I found that a low dose of Abilify - 5 - 10 mg helped my restless legs and somewhat helped insomnia if I took it at night. Magnesium also helps the RLS somewhat. What may have helped more sounds like an old wive's tale - putting soap under the lower sheet - look it up! Also your iron has to be better than low normal, so just not being anemic isn't good enough.

@carrie96
P.
S. if the RLS is mild, I also find that stretching legs for at least 100 seconds helps.

@suzleigh I tried ECT for about 6 months and all it did was mess with my memory. I'm taking Cymbalta now and am researching EMDR. I won't do TMS either. It's just my opinion, but I'll never let them zap my brain again in any way. I'd rather fight thru it. I'm 60 years old and I only have 1 daughter and a granddaughter left alive. I'm a widow of 10 years now and all but 2 deaths were expected...my parents. I want my memories bc as I get even older and start to lose them naturally, I'm hanging on to the memories I have and not gonna risk getting zapped and losing more...just my thoughts..hugs

@abosier65 Don’t blame you for your feelings with brain zap. The couple of weeks I did ECT, I felt that it actually opened up memory connections. I’ll be starting TMS in a couple of weeks, noting this is not a brain zap and there is no need to be put under for it.

My new therapist does do EMDR and may be doing that in the future, but right now I have no full memories to get over.

Still not on any anti-dep. My damaged brain just can’t handle it.