Where to go from here?

I've had a diagnosis of "recurrent, severe, treatment resistant depression" for going on 20 years. It has been a problem for longer than that.

I have tried many kinds of meds, and have been disappointed with the results (as far as I am concerned, they are not a particularly useful option for me).
I have tried talk therapy, self-help, lifestyle changes, you name it.

What seems to REALLY work for me - but only if it is persisted in over time - is a combination of these three things (and it HAS to be in combination):
* Clarifying my personal values and committing to living by them;
* Insight-oriented psychodynamic therapy (to figure out where my issues originated and how they operate);
* Action-oriented Cognitive Behavioral Therapy (with an emphasis on behavioral change).

I sometimes wondered what's wrong with me, since many things can cause depressive symptoms or be comorbid with them. I have had my thyroid, blood sugar levels and testosterone tested - all normal. I have taken every respected self test I can get my hands on. The results of these tell me what I already suspected: Social Anxiety, Low Self-Esteem, Learned Helplessness, Avoidant Personality characteristics (but not a Personality Disorder, apparently), and pessimistic rumination (optimism and I parted ways some time ago it seems).

People who have known me well over the years are always giving me these kinds of well intentioned comments: "You need to be bolder, you're too timid"; "Why do you let people walk all over you?"; "You need to show the courage of your convictions"; "You're a good person who can't see the good in himself"; "You need to work on your self worth"; "Why do you always hesitate over everything?"; "Get out of that 'shell' of yours"; "Don't let the competition or the naysayers get you down". They're all totally correct.

Meds I can afford. They consistently don't work as well as I would like, or don't work at all, and I collect side effects the way some children collect Pokemon. Books I can afford. Sometimes they help a bit, sometimes they make me feel even worse (some authors suggestions seem to feed my depression a three course meal). The one thing I can't afford right now is the talk therapy mix that actually DOES work! *rolls eyes*

So where do I go from here? I've had enough. Right now, beginning today, the BS has to end. I can't live like this. I've been told time and again "You're very high functioning". I really beg to differ.

People who say that can't see what it's costing you to keep "functioning" and they can't see how you feel inside.

You seem to know what will really help you, which is a huge plus. Now it sounds like you have to figure out how to get it for a lower cost or how to come up with the money to pay for it.

I don't know what your current financial picture is like. Sometimes it can be worth it to pay a professional financial advisor to help you figure out how to meet your goals.

I suppose I'm just basically encouraging you to take another look at the "can't afford it" statement. There may not be any viable options. I don't think it ever hurts to brainstorm ideas, though.

Sounds like what my first therapist called negative self-talk. I wasn't able to stop it on my own; I had to be medicates. But maybe you can get better at identifying it and stopping it before it paralyzes you.

Hi Onward,

I've got something you can try right now, today, as you say:

http://egg.bu.edu/~youssef/SNAP_CLUB...0164151576.pdf

It might sound superficial or even silly to you, but it is very easy to try and can really do a lot and quickly. See, for example, edmerch's experience

http://forums.psychcentral.com/depre...epression.html

I don't know what you've tried, but there really are quite a few things to try for depression that are safe and often really work such as dietary improvement, vitamins, getting better sleep, exercise, meditation, yoga,...:

http://forums.psychcentral.com/4262681-post105.html

These things are just great for your health anyway. There is nothing to lose in trying any or all of them.

- vital