So I saw my pdoc this morning and he added Mirapex to my meds for the mean time but he also laid out my options. None of them are great and all require me to take time off of work which I am not sure I can do right now.

So the options were:
Do another full course of ECT - this is his preference

Do a Ketamine drug trial

Change to an MAOI but to do that I would have to go off all my current meds for a weeks and he wants me in at least a day hospital while doing that

Inpatient - He said him and my T are counting on me to let them know when I need to go to the hospital but I told him I probably couldn't do that.

I don't really like any of these options but I need to choose one of them. To do ECT I might need to go inpatient because I won't have a way to get to the appointments three times a week as an outpatient. The Ketamine trial is just temporary because after the trial is over I have no way to get more treatments because the closest place that does them to me is in New Jersey. Changing meds is tricky because that will take the longest to work, if it does, and I hate the day hospital. So that leaves the hospital that I really don't want to do again since I did it twice last year.

I just don't know what to do. What are your opinions? Help me hash this out. What are the pros and cons?