My friend is 89 and in a tremendous amount of pain due to degeneration of her spine. She describes her day as spending most of it watching TV and she has less and less social interaction.
When her natural expiration date arrives, she feels she will have lived her life to her fullest and her house will be clean. Her legacy will be a positive one. She has no plans to commit suicide. She laments about living a long fulfilled life and now she is limited due to pain. She is ready to go.

In comparison, I'm 67 and recently, I'm spending most of my time watching TV and playing virtual Solitair--unable to concentrate on either one.
I have some physical pain due to degenerative joint disease & a bunch of other junk, but I've accepted that there is no treatment or meds to alleviate it. I can still do... I just don't--because the "pain" that is more debilitating is the crap that I have going on in my brain.
I am reverting to dread, excessive worry, cognitive dysfunction, losing things, forgetting things...Ad nauseum, and of course depression. All this crap is piling up and will contribute to me defaulting on responsibilities.
After searching, for over two weeks for my green bag filled with my records, I finally found it on my chair today. I had left it in my daughter's car. I had no clue.

I don't have any active distorted thoughts of killing myself. Spravato is helping do what it's supposed to do.

I called social services to find out if they had any services for me. She was kind. My impression is that she thought I was looking for a therapeutic Molly Maid.

I don't want to die when my expiration date comes up.
(Freudian slip)
I don't want my legacy to be that I was a slob. Whatever good I may have done will be dismissed because I lacked Good Housekeeping skills.
What I took away from my conversation with SS is that If I had broken bones, broken cognition, i.e Alzheimers, I could receive services.
I have a broken brain and apparently that does not count.
Lassitude = lazy.
The Spravato, I think, has reached its level of efficacy. I will not kill myself. So when people tell me: " Try harder." "Push through it." " You just can't give in."
Yep...most of my energy is focused on staying alive. "All" is an over-generalization.

Let's face it, I have Treatment Resistant Depression. My Awakening had a false positive.
On a positive note, though, my writing is not as deteriorated as I would expect.
It doesn't reflect the stream of consciousness mode, yet. The worst is not necessarily when my writing stops completely. Sometimes that indicates that my life is A-Ok. On the other hand, my writing may stop because I just can't think clearly anymore. The pharmaceuticals no longer work. I'm just going through the therapy sessions...automaticity...
muscle memory...
calendar reminders...
routine habits...

Mindfulness gone.
Hopelessness here.

When that happens, I will most likely be in a full-blown major depressive series--not just an episode--working on season 47.

I had an appointment with my psychiatrist this past Wednesday. I read him this entry. We've gone back to the drawing board. He told me there are a couple of new novel antidepressants right around the bend. He also revisited ECT. Been there, done that. No thank you.
In the meantime, we've increased the Desipramine by 25mg to 200mg. He also suggested that the next time he sees me, rather than wearing my T Shirt that reflects my irritabilty and inner "Grrrrrrrrr," that I treat myself to a new one with a smiley face...lol
Body mind spirit ☯️ ☮️🌻🎶

As for my friend...I told her I'll hang onto her as long as possible. I won't let her go because she says, "I'm so sick & tired of this pain! I'm ready to go."
I'll help her find resources that give her some relief for her pain. Then she can embrace her natural expiration date knowing she DID live a full and enriched life.

BTW...
The outside image of my T Shirt represents my insides.
It was clean yesterday, slept in it last night and will probably wear it through Sunday...or not.
I AM IRRITABLE!!!