How do you not lose hope

After over a year of trying to get adequate treatment for severe depression, I'm still exactly nowhere. At this point I regret ever trying to get "help." I think being naive and not realizing the full extent of what is wrong with me was better than knowing I won't get better on my own, and still being unable to get the treatment I need. I've reached out to a new hospital, so in theory it could still get better, but I don't believe it. I don't trust Pdocs anymore. I just know that all they're going to do is string me along for months again until it becomes clear that they're not going to help me, either.

Right now I'm back to where I began, trying to do my normal activities while pretending the depression doesn't exist. It doesn't work, there's just no way I can function at a sufficient level, but I can't think of anything else. I'm just about ready to give up, I'm so sick and tired of it. It's so disheartening, because I'm the kind of person who never asks for help, ever. And now I finally did, and it was just a huge mistake.

Hi @FluffyDinosaur - sorry you had a rough experience at the last place you got treatment. Sometimes it is a matter of trying things to see what works. Hope you give it another try and tell the next place what you tried for medicines and treatments and how those worked.

Sometimes each med works on different people and not on others. It has to do with our body chemistry I read. That is one reason why the first or second try on meds may not work but often there is one that can help improve life style.

Sometimes, people try many meds and none of them really brings them back to a comfortable place. My friend was in that situation and was offered TMS Transcranial Magnetic Stimulation and ECT Electroconvulsive Therapy. Talk to your doctor about those as options.

Hope you get the support you need. @CANDC

Yeah, ECT is what I've been trying to arrange for about 9 months now. I'm a slow metabolizer of meds, and I haven't managed to get stable on the meds I've tried. I also abhor all the side effects. Me and my own Pdoc (who's actually known me for quite a while) decided on ECT, but unfortunately he can't do the ECT himself, so he has to refer me to other people. And then the problem comes down to having to convince a bunch of arrogant "doctors" who don't know you and won't take the time to get to know you that you're worthy of their help, which thus far has proved impossible. And the waiting lists are insane, so each referral takes at least 3 months before they'll even see you for the first time. Then they grind you through the wheels of bureaucracy for a few months before telling you to go **** yourself, and the process starts all over again at a different place. I wish it were as easy as asking for help or deciding on a particular treatment, but if there's one thing I've learned it's that asking for help and getting help are two very different things.

It sounds to me like you were beating your head against a wall, trying to get help where there was none being offered. I have a feeling that when you seek assistance from a different mental health provider(s) you will reap more productive results. The place you've been working with is clearly a dud. I can certainly understand why you don't believe things can get better, but truly, they can.

One mention I will make about medication...I might sound a bit harsh, but I'm just coming from a place of experience. We have an illness, like it or not. In a perfect world the meds to treat that illness would have no side effects. Unfortunately, the meds available to us do have side effects (although some meds don't have excessive ones). I hate the side effects; we all do. But it's the old "risk vs. benefit" - if the illness is life disabling the benefit of medication might just be worth the side effects. (I know, it truly sucks.)

Yeah, it definitely was a dud, to say the least. The doctors were incredibly arrogant and the Pdoc didn't even talk to me, not even once, she got all her information second hand. And yet she decides about my treatment and she acts like she's got me all figured out. It's bizarre. I wasted months there. That ended in December and I'm still so angry and having flashbacks to it all the time.

At the new hospital I've been waiting since January, and basically nothing has happened yet, I haven't even spoken to them once, I'm just on a waiting list and I have zero idea for how much longer I'll have to wait. And I feel absolutely certain that when they finally do talk to me it's just going to be a repeat of what happened last time. I'm half inclined to take myself off the waiting list now so I can at least spare myself from having to go through that again. I don't even dare ask any questions about what's happening or how much longer I'll have to wait because I'm afraid they'll take my impatience as an excuse to label me with something and get rid of me (like the last place did).

I'm okay with maintenance meds, I know I'll need those. It's just that meds aren't enough to get me out of this episode, I really think ECT is my best bet for that. I just don't want to waste many more months trying meds I don't want and that haven't worked so far when I've already made up my mind about ECT. I've already lost way too much time on this episode and I really really need to get better so I can work again and try to prevent my career and the rest of my life from going to ****.

The thing is, me and my treatment team, who I've known for a while and who have seen this episode develop from the start, we've tried various meds, and even the most effective ones only get me from severe to moderate depression, and only about half of the days. So maybe I don't want to kill myself anymore, but I still can't function worth a damn. And as soon as I try to taper any of those meds, wham, I'm right back where I started within days. So together we decided that ECT was the best course of action, and we even know which maintenance meds we plan to use after that. It just pisses me off that after all that, the final decision on whether or not I get treated lies with a bunch of doctors who don't know me and won't even speak to me more than once, if at all. There's just no way I can accurately convey my entire situation to them in one 40 minute talk. The decision should belong to me and my own treatment team, not to them.

Hey man, I’m just going to tell the truth for you. I think it will help. You’re just starting your journey of getting better. It feels like nothing is working and there’s no hope. If mental illness was a line you’re right in the middle between start and finish.

I got to the point I gave up and gave in to getting medications right. It saved my life. I literally said, “i’m going to do exactly what they’re telling me to do, to a T, with no shortcuts.” This led to a new antidepressant every 3.5 weeks with a week n change of insomnia each time. I was ****ing serious and ready to go to any length to get medication right.

I learned how to be my advocate for myself. That means saying, “this isn’t working with this therapist, let’s try a new one.” etc...

If you do what your told (this coming from a rebellious person) that’s how you get past the middle of the line to come out the other side. I advise, do everything they tell you and buy in 110%.

I have been serious about my treatment, fighting to get treated, and advocating for myself for a very long time now. I am doing everything "they" tell me, "they" being my actual treatment team, the people who know me. "They" told me to try a bunch of meds I didn't want, and I did it anyway (still doing it). "They" told me to go for ECT, so I did, only to get ****ed over by the so-called doctors who are supposed to deliver the treatment, who don't know me and think they have a right to decide based on one conversation that they're not going to help me.

I found out the hard way that advocating for myself with arrogant doctors who won't listen is the fastest way to get them to hate me and not want to help me. The problem is not that I am not willing to do what needs to be done. The problem is that ****ing Pdocs can't even agree amongst each other about what needs to be done, so I keep getting blocked at every turn when I try to get treated. So tell me, how am I supposed to get better when every time I try to follow one doctor's advice, it gets blocked by another one? I don't have the time nor the energy for a wild goose chase. All I want is to be able to commit to a treatment that works without another doctor coming along with their own little opinion and contradicting everything I'm trying to do.

i know it probably feels like that’s what you’ve been doing. Listen now. Do exactly what they say. No questions. You have to literally fall in line like a soldier. You will make it out if you reach out everytime your hurting, but you will waste so much less time by being a literal follower of the system. After that point, ask questions.

Alright, that last post was before i read your response. If by being assertive about your needs to your doctor leads them to hate you this is not a place you want to be. Anyplace that your assertive about your needs worth being a patient at doesn’t respond with hate. Great job btw still trying meds. It’s not easy but your doing it. Forming a relationship with your psychiatrist or therapist which is congenial, positive and progressive is very sdvisable in this situation. No worries man, keep trucking til you find that person that clicks. I know your angry, but your serious about it I see now. You’ll make it, because your trying to do the work. Hope’s a tricky thing when your in hell. This is a journey that you sound like your onboard.

Yeah, you're right that when a Pdoc doesn't want patients to have a say about their own treatment, it's time to run away. For me, being involved in my own treatment is one of my most important coping mechanisms. The problem is that with ECT, the waiting lists are so incredibly long that just "trying out" a new hospital can easily take six months. Meanwhile I see my life ticking away and my career going down the drain because I can't work properly as long as this episode is going on.

I have a good relationship with my regular treatment team, that includes my therapist, my regular Pdoc and the Pdoc from my crisis team. Both those Pdocs support me going for ECT, in fact they've both given me referrals for it. What makes it so frustrating is that they're not the ones who have the final say as to whether or not I get treated, because the ECT is handled by external doctors. I have to wait for months and months just to get a chance to talk to the ECT doctors, and then I have one short window during which I can convince them that I'm "depressed enough" (i.e. I have to fit their stereotype of what a depressed person should look like). If I fail to convince them, then it's over and I have to restart the whole process elsewhere. That's just completely unfair because I'm not someone who shows their emotions on the outside, especially to people I don't know, so Pdocs who only see me once can very easily get a wrong impression of me. And that is exactly what happened at the last hospital. Right now I'm just going crazy because I feel sure it's going to happen again and then I don't know what the hell I'm going to do.