[sdav80]

I've been feeling very depressed (even more than usual) despite the fact that I'm taking Wellbutrin (300 mg/day). I've asked my psychiatrist to up my dose, but he refuses despite the fact that I've had no adverse side effects from Wellbutrin. I've tried many other meds-a whole host of SSRIs, SNRIs-but only Wellbutrin actually helps me without all the usual side effects.

Additionally, I try to exercise several times a week; eat a very healthy diet; I've gone to yoga classes recently, I try to take downtime when I can, which isn't often, but still.

So my question is: how come I still feel like I'm spiraling down into despair, and loneliness, headed back into a major depression? I'm starting to get that dead, detached feeling every morning when I wake up. Has anyone had experiences where they feel like they're overwhelming their meds ability to work, and what do you do about it?

I know that some of this is due to my living circumstances: I'm a senior in a private, very demanding college that I quit my job for in 2008 to attend (I'm 31-not a typical student), bad off financially, in a relationship that I'm not certain about at all (and can't leave, because of the aforementioned finances). Additionally, I have 2 little boys. I don't have any family or friends that I can turn to for help, or go live with to get out of this situation, as they've always tried to be harmful rather than helpful. But I can't do anything about this situation right now-I feel like my only hope is meds.

I'd appreciate hearing from anyone with an experience like mine, or helpful ideas.

[agma]

My pdoc added Seroquel to my anti-depressant. That helped a lot. I also know people that have added Abilify to their anti-depressant and that has worked well for them. Also, therapy has helped me a lot....having someone to talk to that is supportive and non-judgmental. Good luck and hang in there.

[Omers]

I was on 300mg of wellbutrin, went up to 450 (the highest dose) and started having petite mal seizures even though I had no side effects on 300mg. Also, many insurance companies will not cover 450mg of wellbutrin because there is no 450mg pill... you have to take a 300 and a 150 or 3 150's.... a dumb insurance glitch but we had to fight like h*ll to get my insurance to cover mine. My pdoc added Zyprexa when things got nasty and that helped. There are a lot of atypical antipsychotics that boost the effects of wellbutrin. I have also used Abilify to boost the effects of my antidepressant.

[online user]

I was doing poorly dispite counseling and doing a lot of work on my situational issues. I do have a genetic-based depression and will no doubt take life-long meds. I take 120 mg of Cymbalta and 30 mg of Remeron. We recently added Abilify as an addition, and what a difference! I have days I feel positively sunny!

Your pdoc may be wanting you to deal with your situational issues which are no doubt bringing you down. See if you can't get the add-on rather than a dose increase. Let him know that you can't deal with some of the other issues until you finish school. One thing at a time is usually easiest. 1. Finish school. 2. Get a job. 3. Decide about the relationship. Of course, you still have the kids to parent, no matter which of the other issues you are working on. Good luck to you!

[sdav80]

Thank all of you for your responses & ideas.

I thought about asking for an add-on SSRI or SNRI, but I don't respond well to them. I'd get super irritated for no reason, or be argumentative, just lots of overall agression. I know that Wellbutrin is an atypical antidepressant, but I don't know why this one in particular has always worked so well for me. I feel kind of panicked that it might be losing efficacy.

I was seeing a therapist during the school year through my college's counseling program, but over the summer I'm on my own. I didn't feel like I had a great connection with her, but still it did help. But without insurance, I can't continue over the summer. There are some free programs in the area that I've accessed, but the wait times are months long. I don't have anyone else to talk to-as I mentioned, my family is harmful, and since I've spent the last few years in college where everyone is 18-22 yrs old to my 31, it has been difficult to find enough common ground to even spark a small conversation.

I'm not sure how to improve my situation. I have a little work, but not enough. I'm very frugal. I don't get enough child support for my oldest son, but that's always been the issue. My relationship is not abusive, and he isn't a bad person at all, however when I'm upset he has this knack for saying things that make it worse even though he's trying to help. I can't move out-I have one more year of school left, and I don't have anyone else I can go live with, and I can't maintain a place on my own. I know it sounds like I'm in this position because I made lots of bad decisions when I was younger, but having a family like mine, that is to say harmful at the least and downright abusive at its worst has left me with very options at key moments in my life.

I think that what's making me feel so bad is that I truly can't see any way to change my circumstances. I can only live them. I'm existing, not **Living** in the hopes that someday (and it's so difficult to think of the future "someday" when you're depressed) after I graduate things will be different. In the meantime, I'm powerless. I start most days trying to think of positives, but there are so few that I feel dejected by 9:30, and ready to crawl back in bed. It's so frustrating to intellectually know what's wrong with me, and options to fix it, but still be unable to effect any change in my mood.

[shezbut]

Hi sdav80,

I do have treatment-resistant depression as well. I take Effexor XR 300 mgs/day and Seroquel to pack more of a punch. Combined treatment, I think that's what they call it.

Even still, I am low. I go through very hard times & haven't gotten better than being in a "moderately - severely depressed" state of mind. That's just the way that it is for me. I do exercise regularly (that seems to work best for me), and appreciate nature whenever I can in tough times. I have identified nature as being my happy, "safe" spot. It brings me a sense of peace and tranquility. I therefore remind myself of nature's beauty very often, to get me through.

I do agree with others, that you have stressors which probably do add to your depression. Recognizing that could bring you a small sense of peace. College doesn't last forever. The end will come before you know it ~ and then you'll kind of wish that you could go back into that "safer" environment ! Do see a T, if you aren't doing so already, to help you work through the emotions that you're struggling with.

Best wishes to you!

[Symbiosis]

I can relate to what you are saying and have felt like you do. I also take the same dosage of Wellbutrin, eat healthy, and just got into a yoga routine that I love 3 months ago. I'm even a non-traditional student, but without kids & a relationship, but with a full-time job. My friend circle is small.

But I do go to therapy and that's been a pretty big help to me. My T is a proponent of MCBT, which is something that is a lot more involved than this but can be summarized by: Wherever you go, there you are. In relation to depression, it is kind of like acceptance of your feelings, even if they are crappy, without judgment, without rumination. Like worrying leads to more depression, leads to more worrying, etc. I wasn't a fan of the idea when I first heard it. I thought it was hokey. But it made a difference(along with therapeutic support).