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?

I've got no future but (more) immense suffering.
It's inevitable given how society now is, how fractured and atomised it's become since they decided that "there's no such thing as society". I need a f*g miracle to escape this situation.
They need to legalise voluntary assisted euthanasia on mental health grounds. Obviously they don't want this because of how it makes their shitty society look. They know vast numbers would apply. They might be forced to legalise it eventually anyway cos it's causing too many disturbances on the rail network.
Fk them.

I had a friend who sounded very similar to you once OP.

Meds aren't going to help you. Nothing is going to help you while you're in the mindset you're in.

What is it you want? What does help look like?

What is it does not being depressed looks like to you?

3rd time asking. What else have you tried aside from medication?

have you tried different psychotherapies? Which ones?

do you have any other diagnoses aside from depression? Don’t have to say of course.

Yes, low dose antipsychotics would be something I would ask about if not tried. I have a few friends with treatment resistant depression for whom this was the answer.

I'm sorry I haven't replied to everyone who's kindly tried to help me or asked questions on this thread

My head is all over the place.

Try to make an appointment with the GP if you haven’t managed to yet. You need some further support and I think you will feel a little better knowing something positive is in the pipeline

Actually, you're in no position to know if medication will help the OP shift their perspective. Not even a psychiatrist would claim to know that.

OP, you're wasting time being angry. The world is desperately unfair to many people. We all know this.

Your GP is not going to be able to alter your medication in the way you hope. But they can refer you to the crisis team who, if you tell them what you've said here, may well get you in front of a consultant.

I know you don't like going outside but you can continue to go downhill or push for help by saying that you are actively very suicidal and requesting the support of the crisis team.

Anything else is wasting time. The system copes with emergencies like that. If you don't do it like that, you're not going to be treated as an emergency. If it is an emergency, it's worth leaving the house over.

Have they tried you on the old style antidepressants? I know they don't like to prescribe them now in any adequate doses but a psychiatrist could give Amitriptyline or Imipramine.

F***g state of that

https://www.bbc.co.uk/news/articles/cn5d2r0zqvdo

How can six year olds be in MH crisis? It’s bonkers

My Drs said the same to me, but after going back to them sometime after that comment they did refer me to a NHS MH facility where I met with a MH pharmacist, she in conjunction with the MH Nurse at my surgery are trying alternatives, not found anything that works yet but early days, I feel im being listened too and they have much more knowledge than the GPs. I think you need to insist that Drs refer you. I also agree showing them your post will make them do something. I really hope you get the help you deserve ❤️

Apologies if this isn’t relevant (and feel free to ignore) but have they given a reason for refusing ECT?

I was offered it in the 90s, when it was back on the table (after the Cuckoo’s Nest years), for just the kind of experience you’re describing. I had tried around a dozen different meds and combinations with very little improvement and ECT was considered a reasonable option.

I didn’t manage to do it, mostly due to the logistics of needing someone to help with the GA, and for whatever reason I began to improve without meds, which can happen.

I’m asking because I wondered if it’s a matter of it having fallen out of favour (again) as a treatment or if it’s worth pushing for a second opinion.

I’m sorry you’re having such an awful time, I feel for you ❤️

Have you tried altering your diet? Try keto. It sounds weird but your gut biome (which is affected by what you eat) can be made healthier by changing your diet.

I'm in the US so take this for what it's worth, but a friend of mine had great results with ketamine. Another is currently having TMS (trans cranial magnetic stimulation) which is showing good results. If you haven't tried those, you still have options. Please don't give up.

I hear you op. Just wanted to offer kindness from an internet stranger and a hug.

I've read through the thread but can't find if you're under the care of a psychiatrist rather than your GP.

There are medications and treatments (such as ECT) that a GP cannot prescribe for you. A psychiatrist will also complete a full assessment with you to formulate a diagnosis and discuss treatment options and plans.

If you are still actively suicidal you need to call NHS 24 asap and make sure you explain your plan and intent to them to that you can be seen by an unscheduled care team from psychiatry or a crisis intervention team.

There is no point asking for help in my experience
I already rung NHS 111 this week and told them I was planning to exit
Unless you're actually in the process of self deleting they're not interested

The mental health crisis is far far too big for them to handle that's the bit they're not telling you

And you ain't seen nothing yet
Social media makes certain that lots and lots and lots of new victims are created daily
And no matter how many people it destroys they're not getting rid of it
What a fucking hellscape this is

I'm so sorry things are so difficult and bleak for you. 99% of GPs do not have the skills or knowledge to manage your prescribing and yours clearly doesn't. You need your medication to be managed by a psychiatrist. You absolutely haven't exhausted all the options. Please get a phone appointment with your GP, write a list of your symptoms (be very frank) and ask for an urgent referral to secondary care mental health to see a psychiatrist. You are right, it's not fair for you to suffer like this. There is help that's more suited to your needs, either inpatient or outpatient. I am willing you to stick with it and get the right help x

OP have you posted before?

Yes many times.

Just posting to check how you are this morning op 💐

No advice but I hope you can find the strength to make the gp or the crisis team hear you.

I know through an experience with a family member that with the NHS atm, you need to be in peak physical and mental health to have the strength to negotiate your way through it. Oh the irony!

Can I ask a really basic question? Have you enough cash to run a basic Medichecks set of bloods - including ferritin, vitamin D and vitamin B12 by checking homocysteine? You could even tag on an omega 3 panel

you have posted in mumsnet so you still have hope. Please do this and check where your body is

ps when my vitamin D and ferritin drop, it makes me feel v low and I found this out by running private tests

I'm hoping to go to A&E tonight to tell them I have to see a psychiatrist ASAP and get put on Lithium , an antipsychotic or whatever is appropriate, in addition to my Mirtazapine & Venlafaxine. I'm just in a terrible trap and it's absolute hell.

Hi OP, sorry you're feeling like this. Have you tried therapy? Medication for depression is poorly understood and certainly doesn't help everyone. Your depression is not necessarily treatment resistant but medication resistant- it sounds like I'm being pedantic but therapy could really help?