I'm suffering a treatment resistant episode of depression that has lasted for two and a half years. My history of major depressive illness goes way back over thirty years. In that time I've been hospitalised, medicated (on and off with TCAs, SSRIs and SNRIs) and therapied. So it is fair to say that this isn't just a minor period of the blues.

Over the years I've developed coping strategies and worked hard to keep myself as well as I can and hold down a full time job. I know what the statistics are like for people with mental illness and they are not pretty, we live shorter lives, we suffer discrimination, are more likely to be unemployed, etc, etc, etc. I've put a lot of effort into trying to break that mould. Part of my managing my mental health so effectively meant that I was discharged from pdoc care quite a long time ago and since then my GP has managed my meds.

During my current depressive episode, I've had the following meds, Prozac (pooped), Zoloft (allergic reaction), Citalopram (inadequate response or pooped before it even started) and Effexor (side effect burden now outweighing the benefits). In previous episodes I've tried a fair few TCAs and the ones that worked have since been withdrawn. My GP has run out of prescribing options, anything that is left has to be prescribed by a pdoc and so my GP made a referral to the local MH service.

On Thursday, I had an assessment with a shrink nurse, the whole experience was vile, but the worst part of all was at the end when the shrink nurse told me I don't meet the criteria to be taken on by the MH team, and therefore I won't get an appt with a pdoc and she will pass my care back to my GP. I explained about my meds and she said that it was up to my GP to prescribe!!!!!!!!!!!!!

So am I being unreasonable in thinking that I should at least get one appt with a pdoc to sort my meds out?

I honestly don't know what to do, I'm seeing my GP again on Wednesday, I'll ask him to refer me for a second opinion, but knowing the way the system works I expect the outcome will be the same.

In the meantime, I've weaned myself down from 375mg Effexor to 17.5mg, this was done without telling my GP. I know that it was a high risk strategy but the side effects had become unbearable and the only alternative that I could see to coming off Effexor was checking out of life once and for all. The withdrawal effects have been unpleasant but manageable and far less unpleasant than the side effects I was suffering.

I don't know whether this post is a rant or a question but if anyone has any suggestions or advice I'd welcome your support.