Failed ECT, Failed PsychoTherapy, Failed Medicine

Where does one go when they have exhausted all medication options, all therapy options (group, individual, etc)., and even did over 24 treatments of ECT with no success? I'm feeling at a loss here. It seems like professionals don't know where to go. Bloodwork shows nothing so far in terms of other causes of my unidentified mood disorder, and TMS isn't looking promising or helpful.

If anyone's been here, Please help

I'm sorry you are experiencing so much difficulty. Unfortunately I can't be of any particular help. But I wondered if you are familiar with this other Psych Central sponsored website for people with unrelenting depression & anxiety:

Project Hope & Beyond

Have you tried ketamine?

In some countries people who are treatment resistant can access to ketamine programs

When you say failed medication, can you elaborate?

If you've not failed with all talk therapies and more than say 30-40 meds combos, including MAOI's, then you can't really logically give up on those approaches yet.

If you have failed with the above, have you considered mushrooms/LSD? That's what I'm trying next. They shouldn't be illegal so I have no problem with it and there's increasing amounts of data showing how incredibly effective they are for TRD.

I've tried Ketamine, ECT, hypnotherapy, 60+ med combos and nothing has worked. I've had TRD and TR OCD for 23 very long years.
Pete

I'm in a similar situation. I've nothing to offer other than that you are not alone.

Hello Enyapla. I am so sorry you are struggling. Depression can be really tough. I have been there...wondering what to do next. I gave up on meds a long time ago...didn't do anything for me other than bother my body with side effects...some even made the depression worse. Are you living with unipolar depression?

How about a holistic approach? Small steps, slowly over time, not a quick fix. Balanced diet, physical exercise (any movement you can handle), guided meditation, mindfulness, gratitude list each day, night positives which you read every morning before you get out of bed, acupuncture from a TCM doc (really helps me), consult with a naturopath (doctorate in naturopathy) if you like how those folks think.

There are a lot of options out there if you step outside of the allopathic medical model for a while. Having been down that path more times than I could count, I am not a fan to be honest...as far as healing from depression goes. Unlike you, psychotherapy really helped me at different points in my life though I'm not currently in therapy. Did you ever have a nice, kind therapist? Someone with a lot of experience as well as compassion?

Here's a link to a thread I created for folks who deal with depression and anxiety without drugs. I think there are some very interesting ideas on there. We're all unique, right? For me, it's about finding your own mix of things which comfort you.
Managing depression and anxiety without drugs

This might sound silly, given everything you've tried, but have you heard about the 52 Lists for Happiness notebook. I recently purchased one and it's already helping me. Check it out online. If you don't feel like buying one, I created a thread where each week I post a new list along with the action cues. They are small, manageable ways to increase your happiness level.
52 Lists for Happiness

A few more links which may help you:
Gratitude?
Share some music that soothes or energizes you
Share something nice that you did for someone
The Kindness of Strangers
Something goofy to make you smile for a moment!
Remembering compliments to feel better
What does your depression feel like?

I also REALLY recommend the documentary 'Happy' on Netflix. Provides research from all over the world on what helps to make people happier. I watched it twice and took notes. There are practical ways to improve your level of joy. Truly.

Feel free to PM me if you'd like.

Peace and healing energy to you

I'm so sorry you're struggling, Enyapla I wish I've had more advice to give to you. Please don't give up. I know things seem pretty hard, but trust me when I say that they can get better. Don't give up hope. Is there anything we can do to help you? Please let us know. Do you have a support system IRL? Any friends or family that may help you? I'm so sorry. I hope you'll feel better soon. You can do this! You're strong, I know that. I believe in you. Remember that we're here for you if you need it. We'll listen to what you have to say. We care about you. I hope writing here helps a bit. I'm here for you as well if you need it. Feel free to PM me anytime. Let me know if I can do something to help you. I'm so sorry you have to deal with this

No offence but this sort of stuff for severe treatment resistant depression is like pissing on a forest fire.

My depression has often been severe. And drugs never helped me. I've lived with it my whole life since the age of 4/5. I shared strategies which help me get from one day to the next. If you have an immediate one-size-fits-all cure for severe treatment resistant depression, please share. I would love to hear it and would probably try it myself.

Same here, except for the ECT (which doctors aren't recommending and I'm hesitant to try). Also, I haven't tried all drugs, but gave up on them after they all did basically the same thing (nothing).

My only suggestion would be to get a referral (if possible) to another specialist. Who knows... maybe one of them will be able to help, even if hopes aren't high. The same goes for talk therapists, where there's even more variation.

Have you tried MAOI? Reversible and irreversible ones? These are the only ones I haven't tried yet. SSRI and SNRI make me feel worse, tricyclic antidepressant and other atypical ones don't work at all or partially work. Concerta didn't work for me either. I have also tried AP and mood stabilizer that made me feel worse.

(And atypical ones: Tianeptine? Mirtazepine? St.John Wort?...)

I have not tried these, mainly for fear of the side effects. Maybe I will if the doctor agrees. Thanks for the suggestions... something like these may well work, given that I seem to fit the "atypical depression" profile.

The reversible MAOI moclobemide has fewer side effects than the older MAOI, it has been proven useful when other ADs fail.

I hope Enyapla is doing ok. It's been a while since he logged in. He deserves to get better and to feel good. I hope he'll come back and read this thread. Sending many hugs to him

When my Psychiatrist diagnosed TRD. He decided on stimulants as they are an off label treatment. While I can't use them every day. They do allow me to be functional 3 to 4 days a week. I did many antidepressant and ECT. No help

After he retired and 3 year later new psychiatrist who has time every 2 months gave me new time released stimulant supposed to start with fast stimulation then maintained through 14 to 16 hours. It has never worked. Today I after being awake but anxious and depressed added my old stimulants. Then felt better. When it started to fade took another dose felt better. But no more today. I am quitting this new one. I once tried concerta which was time released and did not work. All. My best to all but please no hugs. Barry

I feel your pain Barry. A lot of the generic Rx drugs come from India and many of the ADD meds are hopelessly weak and ineffective. Aurobindo ? is a generic many people post negatively about. Perhaps try another brand if your pharmacy will order it. Why not start a thread asking for opinions for the best generic available now (for thetype stim you take)??? Also....It seems the quality/potency changes even with-in brands every year or so...so be prepared to change brands occasionally.

Just a thought Barry...Why not make the thread now so when you are at your next Dr's appt you'll know which brand generic to request. Otherwise you may get corepharma (or w/e the new dud is) & you'll be stuck for another 2 months w/ ineffective meds.

TRD is hell on earth & pure misery for me too. Hope you get the right meds.
maydaymayday