Treatment Resistant Depression (sensitive content)

[SB1967]

I suffer from very severe depression.
They've told me that according to their records I've tried every available antidepressant.
In April I saw a psychiatrist and asked for electro-convulsive therapy , which they rejected. I've tried to beat this depression with gym work, cycling and other exercise. None of it has worked. They told me to go to socials with other people struggling mentally and struggling with social isolation but my depression is just so deep that I don't want to be around other people , especially strangers .
I am now seriously planning my own s***e
I've told my closest relative that "I have to die". I suppose I should see a GP or ring NHS 111 but I'm not sure they'll help me. I'm struggling to leave the house during the day too. I absolutely cannot get out of this. I assume they'll continue to deny me electro convulsive therapy in which case I feel I have no choice but to delete myself.
The depression has become very extreme and frightening and I'm scared it'll turn into depressive psychosis. It's like they're waiting for me to get much worse before they help me. It has been a slow torturous descent into an extreme state and it's agony.

Does anyone have any experience of treatment resistant depression?

Can you print out what you have just written and make a GP appointment today? Ours has a button to press for 'mental health', I think you either need to book an appointment, contact the Crisis team (if you have their contact details) or failing that go to A and E with what you have written and ask for an urgent assessment.

One problem is people don't tell the truth of what is going on their heads to professionals, or they can't articulate it. You have articulated it very clearly and we can hear your distress and disturbance. There's nothing to be ashamed of if the depression is taking a turn towards psychosis but you need to get help for that urgently before it sucks you into another world.

I have also contacted the Samaritans myself when feeling desperate, but that's more for a listening ear which is no bad thing but I think you need more support as well.

https://www.samaritans.org/how-we-can-help/contact-samaritan/

I would also say there are new treatments coming out for treatment resistant depression, some based on electrical signals (not ECT), some like psychedelics which are legal in other countries but not here yet, but I think there are more around the corner so please don't give up hope- this is your severe depression talking and at another time, in another place, you will be glad you reached out for help/

I have treatment resistant depression but most of the time it is mild to moderate and then I’ve had several severe episodes over the years.
You need to tell your doctor how you are feeling.
Have you seen a psychiatrist?
Have they tried alternative meds like lithium, olanzapine, mirtazapine? Are you sleeping?
Sorry you’re going through this xxx

What did the psychiatrist offer you if they refused ECT? I really doubt that you have tried all the possible combinations of medication for treatment resistant depression. Have you had low dose antipsychotics alongside your AD such as Quetiapine?

The doctor just said I'd tried everything.
Which shocked me.
No offer of anything else. No suggestions.
I'm running out of patience as regards tolerating this immense suffering. It's been going on years and years.

Was it the psychiatrist or the GP who said they had tried everything? And have you had low dose antipsychotics in conjunction with ADs?
I’ve had severe depression for decades too so I do understand your despair but it sounds like you are being let down by the MH Services.

Have you had SNRI’s prescribed alongside SSRI’s? It’s very individualised and not common practice but something my psychiatrist prescribed me and it has helped MASSIVELY. Have to keep an eye out for serotonin syndrome but so far I’ve been great.

I'm on a mix of Mirtazapine & Venlafaxine if that's what you mean.

I have been using a flow headset for the last few months it has been a complete game changer I can’t recommend it enough. Recommended it to a friend and her family heard the difference just talking to her on the phone

I see you’re on mirtazapine .. I am currently doing well on duloxetine and have previously been on the usual suspects.

mirtazapine was one of the worst things ever! I hurt all over and my anger was off the scale. The blurb with it says young people may be agitated. It’s not just me, people on the forums have talked about the rage and had fears of losing their families.

What psychotherapy have you tried?

I used Flow for several months last year. Didn't help at all.

I'm just so fucking angry that people like me are just left to rot in agony it's fuckin evil

You haven’t said whether it was the psychiatrist who said you had tried everything as it’s unlikely that you have.

You haven’t also answered whether you’ve had any psychotherapy?

Have you had any blood tests for things like B12, ferritin, vitamin D or tried anything like a high dose vitamin D supplement? I was depressed for years before I started 3000iu of vitamin D a day. The antidepressants I tried didn't do anything.

My mum had ECT treatment, it was the only thing that worked for her, antidepressants did nothing at all. This was in the 90s though, but Im sure it is still an option. Did they give a reason why they wouldn’t use it?

Hi SB1967,

We're sorry you're feeling so low. We can see you're already getting some good support on this thread from other Mumsnetters, but we just wanted to add a few links which might be of help.

Here's a link to our general Mental Health webguide which lists lots of organisations which can provide some real life support.

If you're feeling really low, please call the Samaritans on 116 123. You can also go to the Samaritans website, or email them on [email protected].

If you find texting easier, please take a look at Shout's website. Shout 85258 is a free, confidential, anonymous text support service. Its trained volunteers are available all hours of the day and night to listen and support you to get to a calmer and safe place.

We really hope you're able to access the support you need.

It would be worth getting a private psychiatric assessment and trying some of the newer medication options rather than fixating on ECT. The psychiatrist will be able to put together a treatment plan of therapy as well as medication so don’t despair I’m sure there are still other options for you. 💐

One of my friend’s is on T3 (Liothyronine) for severe depression which was treatment resistant. This has worked for him. Prescribed by a Psychiatrist.

I am also on it for underactive thyroid issues.

I'm heading for a padded cell there's no doubt about that. But in the meantime I'll just go on suffering in agony.
The way this country treats people like me is disgusting. They should legalise voluntary assisted euthanasia for those of us who don't, cannot and will not fit into this rat race. The mental health crisis is obviously too big for them to cope with. And it's only going to get worse. We all know this.

Don’t know if they still have padded cells in the NHS these days but I was in one in the 1990s. Nothing else in there apart from a mat to pin me down on when injecting me against my will. Hopefully things like that don’t happen anymore.

I'm sorry you're in such pain. I understand why you feel there is no way out.

I question if the treatment that has been offered to you is all that's available. Although you probably aren't in a place where you can imagine this, there may well be other treatments or medication combinations that haven't yet been tried. The previous poster saying there are new treatments coming out is correct.

Have you spent time as an inpatient? That is my first thought because a hospital admission is clearly necessary and would certainly be offered to you in my area of the UK if you are clearly stating that you are in the process of preparing to end your life in the near future. You would probably also be offered ECT if the treating psychiatrist agreed that enough medication options had been tried.

I'm wondering if you've fallen through the cracks somehow.

The Californian Rocket Fuel. It's true that this combination is considered the big guns. However it can be augmented with lithium or ECT would be an option if this and at least one other antidepressant had been tried provided your condition is not situational or there is a specific reason why you can't have it.

You have the right to request a second opinion.

Please don't give up just yet.

There are no padded cells in the inpatient units that I've seen. They are by and large the most pleasant parts of the hospital. Not scary at all.

My greatest sadness for you would be that you leave before new treatments are made widely available.

I completely understand your frustration and I don't think it is acceptable for a doctor to tell you that every option has been tried and send you away in this state.