Well, first off, let me state that I am not an "accepting defeat" type of person when it comes to psychiatric conditions. I believe that there is always something that can be done. Thus, I would like to offer some ideas, if you're game.
1) I am assuming you have tried all the SSRIs, SNRIs, and combination therapies (SSRIs or SNRIs with adjunct medication like Depakote or Seroquel)?
2) Have you tried straight-up therapy like CBT (cognitive behavioral) or REBT (rational emotive behavior therapy?
3) Have you been checked out medically as well? Thyroid conditions, tumors, and vitamin deficiencies can affect mood.
I will await your answers...
Dear Dr. Greene, Yes, I've tried all the meds:SSRI's, MAOI's, SSNRI's, Seroquel, Abilify, Lamictal, ad nauseum. I keep getting worse. I beleive that, at best, psychotropic meds take the edge off depression. Then you can apply yourself to the hard mental work of recovering. I've worked hard for years and I feel as though I've lost to a superior adversary. I'm the depressor annd the depresee. Here's the picture: I'm driving in my car, hiking up a mountain, writing, reading, web-surfing, anything. Out of nowhere, a black pseudopod creeps into my brain and I start crying. I say, aloud, "Leave me alone". Who am I talking to? Beats me. I need information. I want to know why no one cares to be around me, or if I live or die; why my children, whom I shielded and nurtured, have turned on me; and why I hate myself. I'm fighting for my life. That's it in a tiny nutshell. SC Komor
Optional Information: Person's Gender: Male Person's Age: 54 Already Tried: Dr. Greene
Do not give up yet! There are still so many weapons in the arsenal, I promise!
So, you've tried the usual medications and they don't seem to work for you. That's valid. I agree that in some cases they just take the edge off. Let's move on to other ideas:
1) Have you been thoroughly checked out medically? Again, tumors, thyroid conditions, and hormonal imbalances can greatly affect mood and I would want to be doubly sure that we aren't fighting a beast that's more physical than psychological in nature. For example, I had a patient once who had chronic hypothyroidism that didn't present with the obvious symptoms. The depression was overwhelming and they just kept throwing antidepressants at it when what he needed was synthroid.
2) Have you been evaluated for Bipolar Disorder? In another case I had a patient who was actually Bipolar, but hadn't had a manic episode in years. The SSRIs didn't work at all, but Lithium did. If Bipolar is misdiagnosed as just straight depression, the right meds might not be on board.
3) Has your doctor ever tried adding a stimulant medication to your regimen (like Ritalin)? In severe cases of depression, this adds back the energy that you've lost, along with the will and stamina to keep going. A vitamin B regimen helps with this too.
4) A Cytochrome P450 test. This is genetic testing of the enzymes that process drugs in your liver. If your Cytochrome P450 isn't working the way its supposed to, you can't metabolize the medicine. If you can't metabolize it, you can't benefit from it. If your local hospital doesn't do the tests, there are national laboratories that do.
I want to keep that little pseudopod at bay.
Perhaps a little history - why do you think your children have "turned away"? What is your relationship like now and how would you like to make it better?
PS - there is no disease in the world (including depression) that can take away what you have done for them or what they will continue to do in this world. You have much to be proud of and thankful for - its just that recognizing this through the fog of depression can be so very hard. I'm trying to help you remember.