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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I've struggled with major depressive disorder for some 10

Customer Question

I've struggled with major depressive disorder for some 10 years now, along with complex grief issues. I've tried a whole battery of antidepressants, new and old; Counselling, EMDR, etc. My condition has never, in the past 10 years, gone into remission. After 10 years of struggling, pain, suicide attempts, I'm ready to give up trying. I'm tired of being tired and ill. It gets harder everyday to convince myself to wake up for yet another day of pain and suffering. I've the kindest psychiatrist who swore he would keep on trying and never give up. But isn't that just futile after all? My quality of life is so poor I don't see any rational reason to keep trying. So shouldn't I be allowed to choose to die as would a terminally ill patient?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

*This website DOES NOT constitute treatment and only provides information and advice in a Q&A format. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.

Hello and thank you for using JustAnswer. I am very sorry that you are struggling with these severe and chronic depressive symptoms, I can understand how distressing this can be for you. Unfortunately you are not considered a terminally ill patient as say someone with an advanced stage of cancer would be...for instance people in chronic pain who have a decreased quality of life would not be considered terminally ill either. I understand you find treatments hopeless considering the lack of benefit from past medications and therapy, but I would not recommend that you give up as there are other alternative options for you to consider. Given the lack of benefit from medications, most likely you have a treatment resistant form of depression so alternative options like Transcranial Magnetic Stimulation (TMS), IV Ketamine, and Electroconvulsive Therapy (ECT) should be considered for treatment as all of these options have high rates of resolving resistant cases of Depression like you appear to have. I do not want to get your hopes up, but these would be the next options for your doctor to consider to help lessen your symptoms of Depression.

If your doctor wants to continue with the medication route than he/she needs to start you on a psychostimulant like Adderall or Modafinil because studies have shown that when combined with an antidepressant or mood stabilizer (Lamictal) the combination can lessen depressive symptoms significantly. I saw in your history that you have not had a psychostimulant so this could also be an option too. But overall I still feel discussing with your psychiatrist about TMS, IV Ketamine, or ECT would be fruitful as well. Here are some studies on TMS and IV Ketamine since they are relatively new compared to ECT and should be tried first.

http://www.mayoclinic.com/health/transcranial-magnetic-stimulation/MY00185

http://depression.wustl.edu/O'Reardon%20Pivital%20trial.pdf

http://www.psychiatrictimes.com/articles/ketamine-possible-role-patients-who-are-running-out-options

Expert:  Dr. Z replied 1 year ago.

I hope this answers your question and gives you some guidance on this issue. Please let me know if you have any questions or concerns as I am happy to assist and support you regarding this issue.

*Please do not forget to leave a positive rating at the top of the page so that I can get credit for helping you. Thank you, ***** ***** appreciate it.

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