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?

Are they referring you for the test OP as hopefully that would be much quicker?

They've not said. I daren't ask.

Surely they are not expecting you to arrange it yourself as they have recommended it as the next step. Please try to speak to them as the situation may be less bleak than it feels if they are referring you.💐

Have you given any thought to going back to a&e during the day time to see if there is a psych?

Yes. But I'm so afraid. I'm probably scared that whatever action they take it'll ultimately result in me being practically forced into ending my own life. Which it feels like anyway.

But you definitely won't get any better by doing nothing.

You might make some progress my going to a&e during the day and telling them you are suicidal and have a plan.

4 weeks ago today I was going to kill myself. I went to a&e a few days later. I saw a psych that day, a week later and I see them again today. I am so much better already and have more good days than bad days now, due to medication and weekly solution based therapy.

I am really worried about you. I understand your despair. I understand how let down you feel. But I want you to get help and get better, because it is possible. I dont know you but I come back here every day to check on you and hope you have made progress.

I just can't believe how tough they've made it for me.
Denying me ECT. Which I understand, it's a last resort.
Then denying me medication for severe depression because I may be on the spectrum. I cannot wait months or years for an autism test.
If I go to A&E and they continue to deny me what they've denied me or I attempt self deletion and they continue to deny me then that's it. I'll have no choice but to kill myself.

At the risk of repeating myself, it really isn’t personal OP, lots of others are getting the same poor standard of MH care and treatment.

You have been given a number of suggestions on this thread, so could you try to work through them?

1. Go back to A&E in the daytime to see if a psychiatrist is available to review your meds
2. Go back to the team who said you need an ADHD assessment and find out how they are facilitating that for you
3. Private assessment and meds review

Fwiw, a number of my fellow patients had ECT when I was in an acute psychiatric ward and none of them found it to make much difference to their mood but they did have quite marked memory loss, so don’t pin your hopes on it as a magical solution.

Hope you manage to get some sleep and feel a bit better tomorrow 💐

I appreciate all the advice I've been offered here but of course you must understand I'm in a very very dark place and scared and finding it hard to make decisions.

I do understand that and I really sympathise. I know how hard it is to do anything when you are so low and you really need more support than you are getting.

OP, do you have any real life support you can call upon? Like others, I'm very worried about you.

A family member is taken very seriously if they are describing situations where you're unsafe. If they also state that they can no longer support you, the hospital has to accept you're in an isolated position. I really do feel an emergency GP apt at which is say you are completely unable to keep yourself safe and have no one at home who is in a position to take care of you is a good first step. But you do have to say the say things - proof your affairs are in order. Evidence of an imminent plan from either you or the family member.

No psychiatrist will refuse to treat a very depressed patient because they are awaiting an autism screening. They will be interested to know because it is important but it doesn't remove the need to reduce your distress in the short term

And yes, some of the ways they assess risk of ridiculous. I once heard a gate keeper tell an outpatient they couldn't be that suicidal because they hadn't yet made a will or given their bank details. No words

I have one sibling. I actually asked him if I could stay with him for a few weeks but he said no. He thinks I want to stay with him and his wife permanently which isn't true. He knows I'm struggling badly and I've actually told him that "I have to die". He thinks it's just talk. Unfortunately it is very likely that this is going to end in my suicide. That's obviously a terrible burden for him but I've got no future but more immense suffering that I can't escape, primarily chronic social isolation.
I do not have the energy to keep fighting this and I'm sick of the never ending hoops I have to jump through and the constant obstacles they keep putting in my way.

It’s strange that they’re denying you antipsychotics. They don’t make you a zombie at the sort of doses they give for treatment resistant depression. At least not once you adjust and are on the right one. Also, many autistic people take them. At mood stabilising doses they can be really helpful for autistic people with certain symptoms.

I’d agree with others, I’d go back to A&E. And I’d keep going back until I got help. You shouldn’t have to, it’s ridiculous, but your situation is clearly urgent.

They don't seem to understand the gravity of my situation even though they heard me sobbing when they told me that they wouldn't give me any treatment before an autism test. I assume that the test is months or years off. I cannot possibly wait this long - they know that. It really feels like they are sadistically messing with me. I'm sure that's not true but it feels like it. I'm rotting in bed rotting in isolation rotting in agony and they treat me like this. I have to be careful what I say here but this could be the final blow.

Op I know a little bit about autism as one of my DD’s is autistic but I am not medically qualified in any other way.

Sorry if this has already been covered in the thread but I presume the reason that they are denying you certain drugs is that they are not as effective, or could possibly be detrimental, to ND brains?

I know an ASD diagnosis is a long way off but it is definitely worth waiting for as if you are found to have ASD, then years of feeling that you are simply “bad at life” gets lifted away. And you can start living your life in a very different way which is kinder to yourself.

In the time between now and your assessment, you could start investigating autism and putting some autism strategies in place to see if they help you. And you could start reaching out to groups of people with ASD as my daughter definitely “clicks” with other autistic people when before she was quite socially isolated.

I want to be very careful about what I say here as I know you are in a very precarious state mentally. A diagnosis isn’t a cure all. Life is still a struggle but it is a much better life when you can live it in an ASD-friendly way.

Btw, I know some people object to the “disorder” part of the ASD label but my dd and I use it deliberately as her life is impacted negatively in many ways by her autism and it’s usually ways that people can’t see, behind the scenes, and as such it’s very socially isolating and exhausting and so I have immense sympathy with what you are going through.

I think in your shoes I would try and reach out to a private autism assessment centre and send them a very measured email about your daily symptoms and level of distress and see if they do any pro bono work or ask at least that they advise you on your next steps?

Op you are so articulate and write so well, you are obviously highly intelligent. Despite your current and very understandable desperation, I hope that you can hang in there long enough for the help to arrive.

I am so sorry that the mh services are so woefully inadequate. And that your brother is so unsupportive. You deserve so much better treatment. 💐

The other thing I forgot to say is have a look at autistic burn out as it is possible that you are suffering with that. Again, I emphasise that I have no medical training at all.

https://www.autism.org.uk/autism-services-directory

I know you are far from ok Op but I hope you are managing to hang in there 💐

As I said earlier in the thread OP I think they think you have behavioural symptoms of sucidal activity and ideation caused by being ND and not a MH condition.

I consider my life to be at risk.
The question of whether I'm autistic or not doesn't help me when I'm very severely depressed and very suicidal and every single second is agony.

Absolutely checkmate. I think this is the end for me. The immense pain means that I'm just not thinking logically. I just want the agony to end.

Hi SB1967,

We're so sorry to hear how terrible you feel. We offer you our sympathy and compassion and hope you will seek real life help although appreciate how distressing it is to be dismissed.

It’s ridiculous. Whether you’re autistic or not, you need mental health help. I can’t see how being autistic would change the meds they give you for chronic clinical depression. I’m autistic myself, and have a mental health history, so I’m not speaking out of school here.

I get the impression that your condition is making it hard for you to advocate for yourself in the face of all this. Do you have anyone who could go with you and advocate for you?

They heard me sobbing on the phone when they told me I'd need to wait for an autism test. They know that this is an absolutely devastating blow. They know that my every waking moment is hell.

I shouldn't have to struggle for help in my terrible condition.

If they refuse to give me medication that could help my severe suicidal depression I'll be forced to kill myself without a doubt. Like I said I've already told my brother that "I have to die".
I have the means to depart this hell which the NHS also knows.

I don't have anyone to advocate for me. I know organisations exist who do this. I barely have the energy to ring for a GP appointment never mind research how I'm going to try to help myself.

If it is any consolation, I'm pretty sure that someone in the situation you are describing won't simply be added to the general waiting list for an autism assessment. My son had an autism assessment while he was under section with psychosis, and I think it was all handled as part of an integrated package of care. It isn't a question of just being sent away to another service. xx

I’m so sorry op.

It’s particularly hellish that you are forced to fight the whole system at a time when you are feeling your most vulnerable.

Please don’t give up. 💐