Yeah, dunno. He says in bp 1 people with anhednoia, amotivation, low energy, poor drive, that there are only three solutions, once the depression element has been maximally targeted. The only AD that has ever worked for me besides Wellbutrin, which I am on a highish dose of, is Cymbalta, but it makes me manic, so, no-go. MAOIs don't work, nothing else works. Ketamine would work, for sure, but I am self-pay and it is thousands of dollars a month. Ketamine is for sure the answer, for sure, but I just do not have the cash for it. It is beyond my reach. And those experimental alternatives are too dangerous.

So, those three solutions are Provigil/Nuvigil, which I cannot take due to side effects, optimizing this D2 receptor thingy with more Abilify, or a stimulant. There are no other options, other than to do nothing, he says. Obviously, as in all things with the illness, balancing one move in one direction against symptoms in another is always there. He does not want me to be unable to work, write, have a life of the mind. Does not want me to just sit around and exist. He was there when my depression was beyond out of control and I nearly died, repeatedly, and we all know that leads to the end for me. So, I am sure it is a risk, but he thinks the potential upside is worth what he feels is a low actual risk, based on his experience in this situation with other patients. Guess we will see.