I've been generally functional, but severely depressed for close to ten years...maybe much longer. I've always tried to just ignore it and go on with life even though it feels like I'm carrying a 200 lb boulder over my head most of the time. But, during the last couple years, I feel like I've just hit a brick wall and it just seems like everything is so utterly hopeless that I can't even push through the depression and pretend I'm a normal person. I just feel trapped and want to disappear.

I've been in therapy for a few months now, but only go every other week because, even with her extremely generous sliding scale, it's too expensive to go every week. I did go to therapy every week for a few months back in 2010 and it helped slightly, but not enough.

I tried a few types of antidepressants in 2010/2011 and didn't like them, but may not have given them enough of a chance. They made me even more tired than I usually am...I was sleeping 14+ hours a day on them. And the sexual side effects were horrible. The inability to climax drove me nuts because that, along with food, have always been the two things I could rely on to make me feel good. So, I would stop taking the meds for two or three days sometimes simply so I'd be able to orgasm.

I tried St. John's Wort which didn't really do anything for me at all. I walk or run every day and have lost 64 lbs and am a healthy weight and bmi, but that didn't really help me. I still feel like a fat, lazy, slob even though I'm actually the healthiest I've been in 12+ years and am not even overweight. I tried SAM-e which has helped the most, but I need 1600-2000mg a day at this point and it gets extremely expensive at that dosage. And, I'm still in severe depression. The SAM-e has just helped me get the energy to lose the weight and start trying to improve my life, but I don't feel it's strong enough. I need something that is really intended for a person with moderate to severe depression and anxiety.

But, I'm scared of getting on antidepressants again. I'm worried they will make me gain weight. I still have 10 lbs to lose before I'm at my goal, but losing 64 lbs is the *only* thing I've done in my life in years that has given me confidence. I need to lose the last ten and I cannot gain any. I can't lose the one positive change I've made.

I'm scared of dealing with the sexual side effects again, but I'm also kind of thinking it might not be such a big deal because I feel like masturbation runs my life sometimes in an unhealthy way. Maybe the antidepressant will help me feel better so I don't have to "self-medicate" with orgasms, and maybe knowing how difficult it is for me to climax will train me to stop masturbating at times when I don't even want to. Currently, there is a very obvious difference to me between the times when I do it because I really want to and when I do it because I feel like I have to as part of a daily ritual or realize I'm doing it because I'm depressed and need some dopamine released.

When I was on antidepressants before, I got angry a lot more easily...I'm usually a very calm and easy going person (well, except for the anxiety, but only I can see that). I made a lot of decisions when I was on antidepressants very quickly which probably shouldn't have been made so quickly. For instance, I kicked a roommate out. But, this roommate had been causing me problems for a long time, and it was probably the right decision to kick them out. I don't know if the antidepressant simply allowed me to have the energy and confidence to make a decision and do what I knew needed to be done, or if it caused me to do something drastic.

I realize antidepressants don't make you into an entirely different person, but it still scares me to think that I might begin making decisions and doing things again while on them that I probably wouldn't do without them.

With SAM-E, I still feel like myself...just with a little more energy and positivity. I just wish it was stronger and cheaper. I feel like it has helped me a lot during the last year that I've been taking it daily, but the progress is just too slow.

The next time I visit my doctor, I'll probably ask him about prescribing me some anyway and just hope I don't gain back 50 lbs and make decisions I regret.