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?

This whole runaround is causing me additional grief that I don't need on top of the hell I'm already experiencing.
It's a miracle I'm not in a padded cell it really is.

What is your plan to help yourself?

I don't see how I am going to get help without either staging some form of public protest or injuring myself in some way
They are making it veru very difficult for me and I'm just getting angrier and angrier and probably becoming unhinged at their cruel treatment of me

I have huge sympathy with OP but I also have to ask this. You have said that you do have savings, so get yourself to a private psychiatrist. This was the advice on a previous thread too.

There is no point fixating on ECT when for all you know this also may not 'fix' you. You havent been round the full gamet of meds as far as you have posted, and yes you may need mood stabilisers

Im wondering if this is why the MHT are suspecting ASD because of a one line fixation and obsession with ECT. What they may see that what you think is depression, being actually behavioural and not a MH issue.

Should you go back in the day then?
I went in around noon one day telling them i had had plans to kill myself. They had to rule out some possible medical cause first but then had me with the psych team by 5pm. Home by 7pm with a new plan.

Its worth trying surely before protesting.

I understand your frustration but you are also playing this game of accessing services in a way that won't bring the results you want.

You have established yourself as someone who talks as if they're suicidal with an imminent plan but then goes away and is capable of keeping yourself safe until you reappear. I understand that makes sense to you but it won't make sense to them.

It is ridiculous for them to suggest that everyone awaiting an autism screening test is barred from emergency mental health care. They seem to be taking the position that time is no factor here. And also looking for excuses to kick the can down the road.

Complaining about the state of the NHS and how badly you've been treated is not the answer. Most people in psychiatric units have a terrible story to tell but at the end of the day, if you can complain so loudly, it means you're well enough to have coherent thoughts about your life in the present and you are in some way invested in what your care in the future might possibly be like. You need to stop complaining. And please don't mention padded cells. It's not helpful to talk about psychiatric units as if they're asylums. There are people who have to stay and work in these places frequently. If you're wanting state of the art help, be respectful about what they're offering. In many cases you will be offered excellent care if you finally get in front of the right person.

Until you have been denied ECT as an inpatient you have no way of knowing if you'd be offered it.

Whoever told you that antipsychotics would turn you into a zombie needs to stay in their lane. It's unlikely to be true. It sounds like you weren't speaking to someone who felt your life was in danger.

If you're truly suicidal and you have an imminent plan to end your life, tell a family member. You will likely have put your affairs in order and have evidence of preparation. Make the family member aware of this. Have them take you to the GP if they can get an emergency appointment or the GP may be able to refer to your local CMHT. It is very important that the family member makes it clear to everyone they speak to that they are personally unable to guarantee your safety for any length of time and that they fully believe you are genuine.

After that you do not agree at any time that you feel safe enough to go home for any length of time. You state that the opposite is true. You don't complain or get side tracked, just repeat your feelings and intentions.

You may have to wait a week in A and E or a fortnight on a medical ward waiting for a bed. In all of that time, you do not agree that you can keep yourself safe outside the hospital for any length of time.

Agreed, I totally understand how difficult it is to take any action when you are struggling so much but that is even more reason to stop stressing about your appallingly (but unfortunately very common) poor treatment by the NHS and take the step to get some help privately.

You have given dubious advice like this before on other threads @Stopthattractor.
It’s really not fair to be saying that the OP will be found a bed in an NHS psychiatric ward like that.

Do not campaign. If you're well enough to do that it's highly unlikely you're sick enough to need a bed. It shows you have the ability to recall, motivate yourself, coordinate, prepare, focus and probably work with others.

Personally I realise these things do not rule out strong suicidal ideation but it would be a more unusual presentation. It would not help your case if your messaging as a patient is to say you no longer care about anything and are preoccupied with preparing for your death.

I think this is the same thread and yes, this is indeed the way it can work. I think you were annoyed because I refused to give details of how I would know. I can't predict exactly what will happen for the OP but this does have a good chance of accessing care. And nothing you've suggested has worked, has it? What does she have to lose? My suggestion places her in a safe place at all times which is more than she currently has.

I was annoyed that you are giving blatantly inaccurate advice to vulnerable people. Other posters have also said that it doesn’t align with their lived experience in dealing with NHS MH services when they present as suicidal.
Your refusal to explain how you know better doesn’t make sense if you are genuine.
My suggestion to get a private psychiatric assessment would help if the OP is able to arrange one. @purplelovecats was able to access the support she needed this way.

Op I am so sorry you have been driven in to such desperate measures like this. The mh services are really inadequate and it’s simply not good enough,

I do know someone who turned up at a police station and received help but I suppose that varies postcode to postcode.

Have you contacted any of the resources that Mumsnet have posted below?

Please reach out to a hospital or a police station. I know you need a professional and ongoing solution.

Please, please hang in there if you possibly can. You have innate worth. And things however painful, never stay the same. Situations evolve op, albeit slowly and painfully. They do change over time,

Wishing you relief from this awful situation that you are currently going through 💐.

I hope you can access some proper treatment options soon 💐

She absolutely can access a private psychiatrist but they will tell her to go to A and E if she's feeling this way. They're not set up to deal with a crisis and would be in all probability requesting to liaise with the OP's GP and CMHT at this time in order to put the right support in place. There is certainly value in seeing a psychiatrist privately but it is not the first port of call in a crisis. Apart from anything else, any medications prescribed by a psychiatrist may make things worse before they get better and that is why we have community teams, crisis teams, even teams who spend a significant portion of their day dealing with admitted patients who can't leave the hospital but aren't yet admitted to a psychiatric ward. Patients can and do wait for days or weeks in that position. Although it's far from ideal and a huge ask of nurses who aren't trained in psychiatric care, these patients are under the care of a psychiatrist, their condition is being monitored, they can be prescribed emergency medication and they have the opportunity to speak with a specialist nurse or doctor every day and sometimes more often. I would prefer to see the OP availing of this.

The fact that I'm not willing to divulge my role on a public forum should tell you nothing except that I have some common sense.

You should be aware that as with everything, standards of care are not uniform across the country and anecdotal experience from one patient doesn't mean that another patient will have the same experience.

OP, you can't continue like this and I'm sorry it's so hard to access support.

Please ask a family member to take you, either to A and E tonight or to the GP tomorrow and have them explain exactly what danger you are in. Every sign that you're at risk must be mentioned. Your family member needs to make it absolutely clear that they cannot keep you safe or provide further care. If it is the case that you know you will not survive outside the hospital, please say this and stay there. It is perfectly alright to say that staying in the hospital is the maximum you can do to keep yourself safe. But you do need to be very clear about what will happen if you leave.

It may be the case that your family member, having provided the evidence that they can regarding your state of mind and actions, then makes it clear that you're not considered well enough to return to the family home and cannot safely return there. I don't know if there are others at home but if there are, this is a moment when there is no shame in acknowledging that their need for a stable environment is also important. Your support system will be taken into account when decisions are made regarding your care during this crisis.

This does not need to happen instead of your attempts to access private medical care.

I am just keen for you to stay in a place of safety and get a clear message across regarding how unwell you are. Please do not harm yourself in the hopes that someone will take you more seriously. It does not work that way. Stick with the truth and remember you have as much right to access life saving care as anyone else.

And the poster above is right about the police. They deal with unwell people all the time and would far prefer you went to them now than then having to search for you later.

This thread has been going for nearly two months so the OP is actually managing to keep herself safe, despite struggling very badly. She has asked for medication change from both her GP and from A&E on several occasions without success so you are being disingenuous to say the least.

That's not the case.

I'm aware of how long the OP has been managing but I'm also that is no indicator that she can continue to keep herself safe. It is a myth that people who talk about ending their lives imminently are less at risk because they haven't yet acted despite talking about it. The OP's perception is that her condition is deteriorating and that worries me. The period of time that she has been feeling increasing levels of distress and the nature of her posts are clearly worrying. If this was a relative we would want them to be in front of a HCP and accessing whatever form of support could be accessed by giving the right people all the facts. It's also the case that there are some pieces of information that might not seem terribly important to us would be very important to a HCP - such as a withdrawal of support from the existing family support network which may well be happening after this long in a state of crisis.

Rather than trying to bicker with me in the mean spirited way you are doing, why not focus your energies on letting the OP know you are there for them on here? It's not as if my suggestions are placing the OP in any danger - quite the opposite.

I have shown support for the OP numerous times on this thread and you are definitely not helping by telling her to go back to her GP, the CMHT or A&E when they have all turned her away several times without support.
I am not minimising her suffering or her risk of suicide either so please don’t suggest that I am.

How are you feeling this evening OP?
I didn’t see your latest post before MN deleted it but I realise you are still suffering really badly. Will it help to share how you are feeling on here?

If you're not supporting the OP to access emergency health care you're a danger.

You have absolutely no idea how the OP is being assessed and at what point further care would be offered. She could present in a qualitatively different manner or saying something slightly different, or - and you are very foolish to overlook the importance of this - with physiological changes or a family member. Or it might simply be a quieter night when the NHS is able to accommodate more patients.

Never advise a person in this position not to bother reaching out to emergency services.

FFS, have you even read her posts.

I listened to this last week, I have a friend in a similar position to you and sent to him.

BBC Radio 4 - All in the Mind, Depression that's hard to treat

It strongly suggest you listen to it, it has a section at the end about new more holistic clinics which have been set up to deal with this to which you can self refer (or get your GP to) and also about new treatments.

Sorry you are going through this, I hope you can find something to help

I'm trying to decide my next move. Their decision to make me take an autism test before anything else has absolutely floored me and obviously made me more distressed. This could take years. In some areas in England the waiting time is fifty years. Yep FIFTY years.

I dont know what I can and what I can't say on here but obviously I'm in very very serious trouble and a lot of it is to do with what the mental health service is saying to me and how difficult they've made it for me at a time when I'm most vulnerable. It feels as if they are forcing me into a corner.