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Long term treatment-resistant depression.

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Posted 8/13/2006 7:52 PM (GMT -8)

Hi, this will be my first post here. I decided to post here because I'm running out of options and hope, and I guess I'm looking for some opinions and ideas about what to do. I've been depressed for a full 10 years. I'm only 20 now, so that's effectively half of my life. My level of depression has fluctuated minimally over the years, 90% of the time it has been considered major depressive disorder, and at best and only for a short while -- dysthymia.

I've been through dropping out of high school, being sent to boarding school, and being involuntarily admitted as an in-patient to a hosptial. I've been through various forms of therapy over the years, with between 5 and 10 different therapists/psychiatrists. I've tried all classes of anti-depressant, various anti-convulsants, anti-psychotics, amphetamines, and electoconvulsive therapy, all with absolutely no success. I would have killed myself years ago if I didn't feel so guilty about it in relation to my family and how they would react.

It was different 7 years ago, before I really started going through my treatment options. Even though I was never truly optimistic that medication/therapy might actually help (as few depressed people actually are) there was still always the thought in the back of my head that there was a chance that I might find something that would alleviate the feelings of depression. But at this point it really doesn't seem like there is anything that can help. So, I don't know what to do. My current psychiatrist said the other day that she has never seen a patient like me, so impervious to the effects of medication.

I'm about as depressed as I've ever been right now and I really don't know what to do. I'm in college and have good academic standing, but I don't think I have the energy/motivation to continue with my classes. What options are left for me? Making it through the past 10 years has been unbearable, and I certainly can't do this for another 60. This really feels like it's my final run, that within the next year suicide might be my only option.  So I'm kind of grasping here, trying to get other people's view points, maybe find out something that I don't know already, find a new treatment or anything really. So...yeah, I guess any input at all would be appreciated.

Posted 8/13/2006 8:17 PM (GMT -8)
Research VNS( Vagus Nerve Stimulator) for Chronic Treatment Resistant Depression. I've really thought about it, and even have a chance to be in a study for VNS, but I'm not sure its for me. Ask your Psy. about it. RESEARCH it though, its permanent and can be dangerous, but no more than taking your own life.
I am only 21 and have suffered from depression and other illnesses for about 8 years or so. Your story is simular. I've withdrawn from college, coudn't handle it. I had most success with Prozac, but I'm not sure it ever goes away. I know(now..) that I am here a reason. I may not know, and may never know why, but God's got something for me to do. But just remember, "we are not home yet". When you know Jesus as your savior, there is hope for the future, and also reason for today.
I pray God gives you and extra reason to smile, and extra reason to Laugh today, and a calm spirit to your soul.
Posted 8/13/2006 8:23 PM (GMT -8)
RonM152, Wow, your truly fighting a tiger. I have to believe you have more power than your giving yourself credit for. You did not accepted the easy way out. It sounds like you are strong enough to move forward in school. If I may, I think you should try to focus on the your near future and not borrow the additional weight of the next 60 years. I have thought suicide was an answer, but like you the realization of it's effects on friends and family brought me back to the reality of fighting for my life. You can do this and I know there is an answer. Please take care. I too am new to this forum. the people here really care and I'm sure they, we can help you move forward. Jer
Posted 8/13/2006 8:31 PM (GMT -8)
I appreciate your prayers and advice. I'm not a religious person and don't think I ever could be, but I'm glad that your faith is helping you get through your situation. For me the depression's not really about life having meaning or not having meaning, or things going my way or not, although it may partially have been in the past. I've looked into VNS, but it seems like a somewhat fickle treatment. The only randomized controlled trial showed no difference between patients with and without the device turned on, and it's approval by the FDA was far less than unanimously agreed upon. The couple psychiatrists I've spoken to about it don't think that it is really been proven to help. So although I am keeping it under consideration, I have less optimism about it than any other treatment I've tried.
Posted 8/13/2006 8:42 PM (GMT -8)

IFIXDIT said...
RonM152, Wow, your truly fighting a tiger. I have to believe you have more power than your giving yourself credit for. You did not accepted the easy way out. It sounds like you are strong enough to move forward in school. If I may, I think you should try to focus on the your near future and not borrow the additional weight of the next 60 years. I have thought suicide was an answer, but like you the realization of it's effects on friends and family brought me back to the reality of fighting for my life. You can do this and I know there is an answer. Please take care. I too am new to this forum. the people here really care and I'm sure they, we can help you move forward. Jer

For someone with depression I am pretty focused on the present.  After 10 years, I have adapted in how I think and deal with it, and do not get entirely bogged down when things don't go my way.  However, with the recent lack of success in treatment and the seemingly limited number of options left, depression and suicide are becoming more real to me than ever.  I've made it halfway through college doing remarkably well for someone with depression, but I am just too lethargic and unable to focus on my work to continue right now.  I get 12-14 hours of sleep every night now, and if I don't I can barely keep my eyes open.  Even when I do, I can rarely do anything useful.  When I read my textbooks I don't absorb the information anymore.  I can finish a paragraph and not even know what I was reading about.  This is especially apparent after the ECT.  I think that if I tried taking classes this semester I would fail all of them.  So I feel there is nothing I can do right now but take a semester off (which I did when I had the ECT), and get a menial job that doesn't require much skill/energy and has flexible hours.  I will use this semester, without the stress of class, to aggressively try new treatments, but I fear that I will not find anything that works and will eventually drop out.  Although I don't sit around worrying about this, I do have to think about it because it is a possible reality as of late.  I don't know...a year ago I was thinking about maybe going to grad school or med school, and now I might not even finish college.  So it's kind of a stressful time with the school issues and the lack of success with all the medications I've tried recently.
Posted 8/13/2006 8:47 PM (GMT -8)
I'm completly understand your hesitation about VNS(I'm leaning towards no, but my depression isn't as "bad" and is could me. and from reading your post, what do you have to lose?? BUT, again I understand what your saying. There is a forum on VNS for depression and a lot of people who actually have one post.
But, as this may be no option, don't give up. I won't say, "You should do this..." because I know what its like, and you'd just me numb to it anyway. But I do want to include, I don't know I could survive without hope in my future. Thats all I am going to say about that.
I do hope things get better for you, and you find some type of treatment to help you get through.
Posted 8/13/2006 10:03 PM (GMT -8)
hi Ron. i salute u for ur strength!

im 21. was dx'd with depression only last year june. but i think i've been living with it since my very early teens. i had the suicide thoughts since i was young and i was 16 when i had the tendencies to actually commit suicide. but i didn't untill last year when i was hospitalized for it and finally dx'd with depression. i took my medication seriously at first but gave it up after feeling like it helps nothing. i haven't try many different type of medication as i have problem with my psychiatrist. he said i make believe of my depression and keep sending me to the counsellor who keep saying the same things which makes me sick and tired of it. maybe i just dont try harder to get better or maybe i cant get better. i dont know. i always lost in those questions. i dropout from university, from my final year of diploma. like you, i just dont think i have the energy and motivation to go to class. when i forced myself to come to class, i would end up feeling extremely irritable and when i got back home i would do things i shouldn't do. i live alone by myself anyway so nobody knows what i do and nobody can stop me. i still have great grades but i just dont think i cant make me go through it anymore. now my decision of quitting my diploma is depressing me. i disappoint so many people by dropping out. now i'm nothing but a living dead, wasting the money my fiance earned for his hardworking. i'm just so useless now. yeah suicide is always loud in my head but it's like there's still a soft voice inside that keeping me alive.

i feel so lousy. i come to think that this is just the way i am - lousy. and no medication can help me with that. i don't even know what the hell i'm thinking.
Posted 8/14/2006 3:14 AM (GMT -8)
Hi Ron, First I wanted to welcome you to healing well forum.  We are happy to have you join our community here.  There are so many wonderfully supportive people here always willing to lend advice and information.  So I do hope you continue to visit us. I too understand your frustration and fears with your schooling and treatment.  I have had major depression, anxiety/panic most of my life (I am 32) now.  It was difficult for me to get through college the first time around on my 4 year degree.  I often took breaks and semesters off to regroup and rest as sometimes the stress of it all was too much to handle.  It took me a while to realize this but college will always be there and you can always go back when you feel more stable and ready too.  So if your feeling that you need a break or it is too much right now than do withdraw from classes before it hurts your student status.  Stress is a huge contributing factor to depression, perhaps you may want to try to eliminate what stressors in your life within reason that you can to help aid you in getting better. I don’t think it is appropriate for us to recommend possible treatments for you as this is something that you and your psychiatrist should be doing.  There are many options out there and please keep in mind that depression is treatable.  They just have not found the right combination for you as yet.  I understand it is frustrating but you have to hang in there.  Communicate your feelings with your doctor and keep on them about it.  I am going to post some links for you just incase you feel you may need them...please use them if you feel your going to harm yourself or reach out to someone for help.  We are always here for you.  Take care http://suicidal.com/depressionandsuicide/ http://suicide.com/suicidecrisiscenter/ http://suicidehotlines.com/
Posted 8/14/2006 10:18 AM (GMT -8)

Hi, Ron, 

Sorry life has been so tough, with so little success from the medical treatments.  You sound a lot like my granddaughter.  You know about the depression, have you considered that you may also have Adult ADD?  Do some more research - all to often these conditions overlap and one is treated while the other is ignored.

Hang in there.  You and your generation are our only hope - when you find solutions for yourself, we all benefit.  You are a valuable  "indigo child" -- look that one up, too.

:-)   Martha
Posted 8/14/2006 7:55 PM (GMT -8)
Hi Ron,

I wondered in reading your earlier post if you had anyone look at your sleep patterns? I suffer from sleep apnea and have had to wear a C-Pap machine to sleep for the last three years. It doesn't completely solve my sleep problems but it does allow the sleep I do get to be more effective. My brother also suffers from depression and sleep apnea and the CPAP machine has helped him when he gets serious about using it. No more advice than that. If your not getting the restorative sleep your body needs 20 hours a day isn't going to be enough. Excercise is also a good way to sleep more effectively. Jer
Posted 8/16/2006 8:42 AM (GMT -8)
Hey RonM, how are you doing today?
Posted 8/16/2006 10:56 PM (GMT -8)
RonM, have you had your thyroid checked? low levels of thyroid hormone can cause depression, which may resolve once the hormone imbalance is addressed. fatigue is another symptom of hypothyroidism. may be worth investigating, if it hasn't already been checked. you can read more here:
http://www.umm.edu/patiented/articles/how_serious_hypothyroidism_000038_6.htm
http://www.biopsychiatry.com/hypothyroidism.htm
http://www.endocrineweb.com/hypo1.html
Posted 8/19/2006 3:28 PM (GMT -8)
Hi Ron,

My thoughts are with you. You had many great replies so I will keep this short..just wanted to ask if you have ever considered alternative medication and therapy with a Holistic Practitioner or I guess they call them Naturopaths? They are very good in dealing with major depression and alternative treatments. They may be able to find a good supplement and vitamin regimen for you.
Posted 8/21/2006 12:38 PM (GMT -8)
I know what you're talking about, i really do. I've been depressed and suicidal my entire life. Endogenous Depression with Suicidal Ideation.
I've been on every type of psych med, combined with other psych meds, and not one has ever had any effect on me. I decided against ECT 'cause in my research i found that it's wildly unpredictable about what it can do to a person; and even in the best success stories it's still temporary and people go back for another round. Pass.

Basicly, they don't know what to do with us, so now there's a new catagory Treatment-Resistant Depression. Well thank you for the new label, that was helpful.
The only thing you haven't mentioned is VNS, Vagus Nerve Stimulation. That's a surgical procedure where a device is implanted that uses electricity to stimulate the Vagus nerve (think of a pacemaker).
There is a specific website for it, but i don't have the URL anymore. You should have no problem finding it, and other sources of info on VNS are pretty common.

I strongly, strongly reccommend you take a look at "Night Falls Fast" by Kay Jamison (she's a Bipolar psychiatrist, and she's done some quite original and ground breaking research) and "The Suicidal Mind" by Edwin Shneidman. I've researched suicide and this is the only guy i've seen who actualy knows what he's talking about. He then founded the American Association of Suicidology. You can check them out at "suicidology.org"; i haven't really checked them out so i can't say anything good or ill of them. I wanted to contact Edwin, and they wrote back, but he retired as director of AAS so i haven't bothered to check them out.

I will leave you with a few pieces of info i've gathered during my research; and the last one, they're talking about people like you and me -major persistent depression that does not respond to treatment:
"Worldwide, 1 out of 5 people will suffer from major
depression, and out of those 20% will commit suicide.
Brain disorders are the world's leading cause of disabillity
from noncommunicable diseases, and their impact is on the rise. "
"Unipolar major depression is the #1 cause of disability in the
Americas, and is projected to be the single leading cause of
disability worldwide by 2020."

"The newest evidence indicates that recurrent depression is in
fact a neurodegenerative disorder, disrupting the structure and
function of brain cells, destroying nerve cell connections, even
killing certain brain cells, and precipitating cognitive decline."


My life is fairy tale, everyone wants to be me,
Poet
Posted 8/21/2006 5:17 PM (GMT -8)
eight days since your original post. how are you doing now? every day you don't die is a success, as far as i feel. i agree with els (moderator) about seeking further professional opinions. i was diagnosed in 1994, and have tried a LOT of different stuff. sooner or later you hit on something or a combo of things that help a bit. help enough to make life worthwhile anyhow. don't give up.

at my worst, the psychiatrist where i was hospitalized made me sign a contract daily, promising to live through the night. somehow this helped, don't really know why....
Posted 8/23/2006 10:18 AM (GMT -8)
I'm not trying to start anything, but i do want to AngMichelle to know that a VNS device is not permanent, a person can have it removed.

Ron, you know when i wrote out my post, i was like the first person to write back and ended up wayyyyy down the line -i hate when that happens, outdated before you're even in print!
I feel for you; i read your tale and it's so like mine....you could be my twin and my condolences 'cause i wouldn't wish that on anyone.


"Am i dead yet?, can i go now?"
Poet
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