Depression: What treatment can I try after so many years?

I am going to try. Thank you for sharing.

I SO recommend a MAO inhibitor. They're under-prescribed because of the dietary restrictions one must follow to avoid a "hypertensive crisis". Generally: wine, fermented and smoked foods (for example, salami, pastrami, some cold medicines, smoked cheese and fish...and more).

Nardil (one of the few MAOs)is the only medication that completely relieved my long-standing treatment resistant depression. Ever so sadly, I turned out to be prone to a side effect - extreme HYPO-tension! I had just titrated up to the dose that worked for me, when this side effect began and I was forced to discontinue it.

MAOs have saved the lives of friends (on and off line), though, and if you haven't tried it, you're letting yourself down. (Note, my saying: "If you can't do without pastrami, you're not really depressed!")

FWIW MAOs increase your available dopamine (as opposed to most antidepressants basically based on increasing serotonin). I decided long ago, that my brain lacks dopamine rather than serotonin. Yes, I've tried buproprion with microscopic (if any) response. I'm on my way to the gym - vital for my physical health as I'm otherwise almost completely sedentary. However, I'll bet its. increasing my endorphins - effect of dopamine - is equally important. SO hard to force myself to it (as with everything) but it's my primary therapy for all my systems.

Shirley Hugh-Jesst | @audriana

Note input from Shirley Hugh-Jesst | @audriana above.
Shirley, hope you see my post.

I am sorry for what you are going through and I am also in your age group and feel the same way...you have a kindred spirit out there.

Hi Linda, I could have written your post word for word, especially the last sentence, can't offer anything more than support and let you know you are not the only one who feels this way.

Thanks for sharing. We're not all cut from the same cloth. I
find JOY in " Crazy Quilts!"
The psychiatric industry must stop following trends and go back to individualized and integrative care.

@lindasmith1222
I read your reply and closed it. I needed time to thoughtfully reply.
In fact, I had an appointment with my psychiatrist yesterday. Amid a flood of Weeping, I mentioned your letter. I told him how much I empathize with you. I don't want to dismiss you. I want to help you.
I think you are doing a great job of helping yourself.
☆You are advocating for yourself.
☆You are reaching out to others.
☆You're tenacious.
☆Your patience is remarkable.
☆ You're selfless.
☆ You're kind.
☆ You're helpful.
☆ You're valuable.
Thank you!
"HOPE IS THE JOYFUL EXPECTATION OF GOOD THINGS TO COME!"

Here's to HOPE for good things to come...
Audrey

I've been on 350mg/day Wellbutrin for ages with no discernible help.
Well except that on the few occasions I've dropped it (cold turkey, quite painless FWIW) I noticed after a week or so I noticed I was a tad worse, so I went back on. Perhaps I should I should go off for the sake of reducing my very lengthy med list!

You may be interested to learn that I've finally -managed approved my doing a trial of buprenorphine (patch form - expensive! 🙁 ). That is after 20 years of research and waiting for the Psychiatric Industry to come 'round to legalizing it (they did!).

It probably helped me getting it approved, that I was already taking an opiate, hydrocodone, for chronic pain, and I'll be replacing that opiate with buprenorphine for both pain relief and TRD - treatment resistant depression.

I've long been convinced my brain has too little dopamine (which this will contain) rather than serotonin which is the basis of most modern antidepressants. (Undoubtedly why NARDIL an MAO inhibitor, was so wonderfully effective for me - heartbreaking that I had to discontinue it owing to a side effect which just happened to be harmful for me.

However, wherever the subject arises, I try to make time to call attention to the dopamine hypothesis to treat depression as I feel sure many who suffer from treatment-resistant depression like me need dopamine rather serotonin.

The buprenorphine is brand new for depression, though it's still considered somewhat experimental for old school psychiatrists. Has been used mostly for detoxing opiate dependent and also for pain. (Google: buprenorphine, Treatment resistant depression)
That said, there have been many clinical trials of buprenorphine to treat TR, but however effective it is, it hasn't been used largely because of the national opiate hysteria.

Good luck finding relief for your pain - likewise for others who struggle to find relief for psychic pain!

After being diagnosed with treatment-resistant depression (and anxiety), my insurance covered transcranial magnetic stimulation, which helped a lot. I also did ketamine treatment, which my insurance did not cover, which was even more helpful.

The next big thing in treating mental illness is going to be psychedelic drugs. The FDA is expected to approve psilocybin and MDMA as treatments for depression/anxiety & PTSD within the next two years, respectively. Experts believe it needs to be accompanied by short, intensive psychotherapy, so this is really considered psychedelic-assisted psychotherapy. This is not using these drugs recreationally. If you’re skeptical, watch the Netflix series “How to Change Your Mind” based on the book by Michael Pollan. They have videos of patients undergoing the treatment in clinical trials, as well as interviews in which they say just a handful of treatments did what years of conventional drugs and therapies failed to do. It gave them their lives back. I was literally in tears watching it.

There is hope for healing by harnessing our own minds with the help of these miracle drugs.

Reading your reply this morning was very timely for me. I got the results of my Genotype Wednesday and I lack dopamine. Wellbutrin is the best choice for me and I am already taking it and have been for decade. I firmly believe it does help me with my depression. However, occasionally I start stressing about the number of medications I take and want to cut back 'on something' but I want to change my thinking since Wednesday's appt and remain on the 150mg of Wellbutrin I take, I also found out that according to my metabolism I only need low doses of any medication I take. In my med experimentation, I have told many docs this over the years because if I take too much, I am sick both mentally and physically with just about all the side effects listed for a med. I 'luv' when I get the answers I search for and persons like you are a blessing for me.