Treatment Resistant Depression

You are so right, and it’s heartbreaking.

You need to connect with NAMI for resources. He should join a nami support group! Psychiatrists only manage medication. I worked 45 years in mental health in Philadelphia, Pa

@tessabutterfield Welcome to Mayo Clinic Connect. You don't mention how old your son is, but I applaud you for seeking out possible solutions to his depression! Having your support is important.

In my experience with depression, I found that what might help one time, may not be a key the next time. I am currently on a low dose of Celexa [this time for 2.5 years now] and will likely stay on this for a long time to come. Included in my arsenal of treatment options is therapy with a professional who deals with profound depression. Also, I use journaling as an outlet to get things out of my head and onto paper, where they seem to have less power over me. Adding in my own type of art therapy [doing something creative to express thoughts], eating healthy, moderate exercise, it all works to help me help myself. It is not a set-in-stone plan, it is always shifting around. I don't chide myself for not finishing a project, because it worked to get me feeling better, even if I change over to something else for awhile.

Here is a link for the journaling discussion we started a couple of years ago. https://connect.mayoclinic.org/discussion/journaling-the-write-stuff-for-you/

Do any of these ideas sound like something your son might want to explore?
Ginger

Hi Ginger,
Thank you for your post! I will check out the journaling discussion link you sent, AND send it to my son for him to read! What you say is so true...as we grow and evolve depression does too. And what may work one time, won't another time. Being flexible is key. My son is 20, but I've been searching for help for him for well over a decade. I love what you said about writing and getting things on paper (and the words losing their power). I'm going to send this to him - it's good to hear it from someone NOT me, if that makes sense. We were able to find a doctor who works with Spravato (Esketamine) and are going to be trying that within a week or two. Spravato just got FDA approved, so insurance covers most of the cost. Thank you so much for your thoughts and tips! I am not stopping until he gets the help he needs. Take Care, Wendy

Hi, your son's struggle sounds relatable.

Are familiar with Gene Sight (and other similar tests)? That's what gave me the information I needed to find a medication that actually helped. I had tried 8 different medications at that point, including ketamine, with no results (and lots of side effects). I should have done this test earlier because I learned that there are only 4 antidepressants that are indicated to work for me. None of the 4 were ones I had tried or that my Dr was planning on prescribing so who knows if or when I would have stumbled upon the one I'm taking now if not for that test. It's too early to see if the medication I'm on will be "the one", but I do feel better than I have in years so I'm very hopeful.

I had been in a therapy for years and a PHP then IOP program (which was expensive) and nothing helped. I was trying to do the work with journaling, mindfulness, exercise, stuff like that, but the depression and anxiety were so overwhelming nothing helped until the medication started kicking in a bit. I'm not "cured", my depression and anxiety are still there, but I have a bit of breathing room now. Some space to really do the work in and out of therapy.

I have ADHD as well and while that's still an issue, I find the depression and anxiety makes ADHD ten times harder to deal with, so as those get better so does my ADHD (a bit).

The test I took is covered by a lot of insurance plans. My insurance didn't cover it but they ended up not making me pay at all. At most I would have had to pay $330 I think, which to me is still a bargain if it would have saved me all the trouble of the last few years. Anyway, if he hasn't taken that, and you have the means, I would suggest starting there to see if it sheds some light on things.

I wish you and your son the best, I know how hard it is.

You are absolutely correct! We need a much better mental health system in this country! Low income care is anything but quality and professional. I lost my daughter to depression and alcohol. The texts from the MH case worker that was supposed to be helping her were appalling! Photos of the woman drinking, partying on a beach I found she sent my daughter. OMG makes me so sick! My daughter didn't have a chance with mental health care like that!!

I highly recommend trying Spravato treatments (nearly all insurance covers it; I pay only $10 per treatment). I’ve had depression for decades. I’ve tried dozens of different medications but nothing worked well enough until Spravato. I started feeling better after 2 weeks. I feel hopeful for the first time in forever. I haven’t thought about suicide even once.

I had treatment resistant depression. I am taking phenelzine which is an maoi antidepressant that is helping people greatly.

Please look into this.

I have had bipolar disorder since I was six years old I am now sixty. My illness manifests as severe depression and manic depression,an urgent desire to kill myself while running around like a madman. They say bipolar depression is different from major depressive disorder but they give me the same antidepressants, so who cares.

I have been hospitalized three times. I've spent six months in long-term treatment. I have had 19 sessions of ECT (shock therapy) TMS. Just about every antidepressant and antipsychotic in the tool kit, I'm on mood stabilizers and I have had two weeks of Ketimine treatment. More psychotherapy than I had money to pay for and I've gotten sicker and sicker. I am now totally and completely disabled. They say I am treatment resistant.

Just about a month ago I picked up a book “Brain Energy” by a psychiatrist named Palmer. He is Harvard-trained and head of psychiatry at Mclaine Hospital, arguably the best in the world. I feel the best I have in my life! I am no longer suicidal and I was about to pull the trigger before I read, this book.

What have I changed?

I exercise vigorously two hours a day weight lifting and cycling. My chosen exercise is just what I like, I don't think it matters what one does. It's the vigorously that counts

I've, stopped two of meds Lorazepam and Seroqual, with my doctor's support. I slightly increased Latuda though I don't think that was actually necessary it helped me discontinue the ones I did and will help me with the remaining 12 I have to go, yeah 12. Some of them are for side effects from the others.

I have stopped eating refined sugar of any kind even the added sugars in everyday food. I further cut my carbohydrates to about 50, grams a day and eat equal amounts, fats and protein, kind of a modified Keto.

I recently had my doctor test my testosterone levels as, I found through research that the symptoms of low testosterone are the same, as, the unrelenting depression I was in. Sure enough all my levels are either low or critically low. I dug a little deeper and found that all of the psych meds save one, Wellbutrin, impede the production of testosterone!

I have lost everything to mental illness, my family, my wealth, my reputation and for two and a half years my freedom! This does not have to happen to your son! I'm and now sixty and am rebuilding a life ravaged by mental illness.

I can not tell you what to do, for me the first step was to realize that for the most part doctors are just as confused as we are. I started asking Google my questions. I read every legitimate paper, article and report I could find. I read Brain Energy. That lead me to start exercising which intern lead to my dietary changes. I no longer accept what the doctors tell me, I do my own research. I have spent hundreds of thousand looking for help and I’ve lost millions being sick. And I never questioned my care, that’s my fault!

Every step I took I felt better. I know have a life and hope, in thirty days. I still have a long way to go but now I can think clearly and make better decision. I am the director of my care, I no longer abdicate my life to anyone.

Imagine if everything I have been through is due to a hormone imbalance that no one bothered to check for even though the information has been available for decades.

I also found a provider who agreed that less is more and has helped me reduce my medication and supports continuing the process. Where did I find her, a community mental health center? Basically free because I am disabled. They also work on a sliding scale. I find people working in community mental health aren’t there for the money they care, though everyone is different.

Make a plan and go after with everything you have. You can change the course of your sons life. Never give up.

Message me anytime, I have a lot of bad Karma to make up for.

Thank you for reaching out!

Are there bad side affects? And does it reduce pain?