is he saying he can't help me anymore?

[blushingm]

i went to see my consultant yesterday and he was saying there is only so much he can do with meds. I've been on citalopram, venlafaxine, fluoxetine, fluoxetine with mirtazapine, fluoxetine with pridel, fluoxetine with aripriprazole and now fluoxetine with risperidone.

He says i have treatment resistant depression and i've had cbt individually and in a group but nothing really seems to be shifting it. I feel so down and have horrid thoughts all the time plus bad dreams and poor sleep.

He said that i am probably stuck in a rut and need to do something to change my lifestyle/life if i am that miserable with life

Is he saying meds won't help and it is all be my own fault or are there more meds/combinations i can try?

I am so confused and feel like i am wasting everyones time and would be better off not here

There are certainly other meds out there, although whether they would work for you, I have no idea.

However, I think he is saying that as meds don't seem to be working at the moment, is there anything that you can put your finger on which makes the depression worse that you could change? Even a little thing?

He's certainly not saying its all your own fault.

thanks GL

I can't put my finger on anything. I just feels like noting in life is worth it. i don't feel good enough at anything. he asked what i wanted when i was younger and all i could think of was a career/university which i never did as i really don't think i'm good enough at anything to qualify as anything

i should be grateful ffor what i have-others have less and arn't acting/thinking/feeling like me

Forget the "grateful for what you have" thoughts, they are irrelevant. You are where you are and it is making you depressed. Telling yourself that you shouldn't be won't help.

I find that I am at my worst when I am sitting still or in the house. Being out of the house and moving distracts me and I do actually feel better, so for me structured activities to be out of the house help.

Also physical activity helps, so I run and focus on nothing else but running.

There are many things you can do, you just haven't worked out what they are yet. Don't give in to despair.

can you increase the amount of fresh air and exercise you are getting ? With spring coming on it is really lifting to get out in the sun and go for a good walk. If you can do that a few times a week it might help make life look better.

i just got a referal to the local gym, via the gp. my assessment is next week - hopefully the exercise will help - but at the moment it feels like nothing will help and i'll be like this forever

It will help. Exercises physically releases "happy hormones" which do make you feel better.

it must be horrible to have refractory depression, think your consultant is being a bit unfair to shift the burden further onto you when treatment options are from exhausted yet

one thing to consider is the possibility of misdiagnosis - am not suggesting for one minute you have these but as options to explore your resistance to the meds so far you could be on the bipolar spectrum (mania can be mixed or dysphoric and look like agitated depression) in which case the anti-ds you have tried so far are likely to make things worse, have an anxiety disorder, schizophrenia/affective, neurological or other underlying medical conditions and so on

sorry if these have all already been ruled out, and assume you have already been through various blood tests to check thyroid etc?

am really surprised you have not tried lamictal (lamotrigine) yet

It seems to me that you could really benefit from therapy. If your consultant says meds are not working, couldn't you ask him/her to refer you to therapy/counselling?

I mean, real therapy, not 6 sessions CBT. (and even if you've already tried therapy before, it depends A LOT on the therapist, so it might be worth another try as sometimes it takes some time until you find someone who can really help you).

PS: in the short term, exercising sounds like a great idea

blushingm, you sound really down. Please get some help as it sounds like you are in a really bad place. I agree with the idea of some therapy, perhaps something that goes a bit deeper than CBT, to discuss what the underlying issues are. Has your consultant not suggested this?

hi RR & SD and MW

he hasn't suggested any other 'psychotherapy' as he calls it

i do have some issues i.e haven't spoken to my mum in over 8 years - she had a drink problem when i was growing up and i can't fprgive her

MW - i hadn't thought of another dignosis - or even a medical problem ???? are there other medications available - i've been googling (not always the best idea i knoww) and it came up with bupropion [sp].

is it possibke to take an SSRI, lithium and an antipsychoti all togther - could that help ?

Hello blushing, I am sorry to hear about your situation. I also had (have) treatment resistant depression (lithium + citalopram seem to be working at the mo). I am surprised that you have not been offered more psychodynamic type therapy. As others say, the therapist and the place you are in emotionally at the time have a massive effect on the success of therapy. You have tried a long list of drugs, I can see that thinking laterally might be the best chance of helping you.
Did the consultant have any other non-drug ideas that he talked about? And have you ever considered ECT?

Another treatment resister here - currently on venlafaxine and als0 rispiridone as required (not every day just now).

Am currently abotu 10 sessions in to some serious psychotherapy and am really starting to see a difference. My psychologist tells me it will be another year at least till we are close to finishing - mother issues here too!

I woudl push for 'proper' psychotherapy - my "head doc" is a consultant clinical psychologist with years of experience and far far better than any other MH professional I have ever seen.

if you are in southern Scotland I can pass on details!

You are NOT better off not here. I know how it feels to think that, but it is a big old fat LIE. The world is a better place with you in it (and 6 weeks ago I didn't believe that about myself either!!)

I had 2.5 years of group 'psychotherapy then a gap of a year and then 1 years of individual 'psychotherapy and it really did help. It helped me look at why I felt the way I did so that I was able to accept what I couldn't change and move on from how it made me feel so it didn't control how it made me feel anymore.

It is possible to take all three together and there are other kinds of medication you haven't tried: a tricyclic or MAOI for instance but there again medication isn't the be all and end all.
A combination bio-psycho-social approach is the best thing so finding a medication that helps at least a bit but also getting some therapy (ask about psychodynamic or CAT if CBT hasn't helped) AND doing exercise or scheduling one activity you enjoy or used to enjoy. I think this may have been what your consultant was trying to suggest rather than abandoning you.

thanks for your replies weegie, car girl & thing

we briefly touched on ect about 18 months ago and i said i'd never ever ever try it - have you had it - what was it like and were the affects lasting?

sadly i'm not in southern scotland (though i am visiting there in about 2 weeks) so thanks for the offer of ther details. if s/he is ever moving to wales let me know!!!

my conulstant is meant to be very good so i'm not sure if i am just not 'getting' what he is trying to do.

what sort of other therapies are there available? mental health seems quite good heree as i only had to wait a couple of weeks for the cbt sessions

blushing - if you are close to Glasgow before 2nd April ci would do coffee/lunch if you liked.

Sadly after that I am away for 2 weeks!

I had ECT in my early 20's - FAB. It made me SO much better so quickly. Problem is it doesn't deal with underlying issues, but at the time the rapid recovery was essential for me.

I'd push to have it again if this therapy doesn't work.

But its pretty hard to get these days.

blushingm I agree with posters who said you should insist on some psychotherapy. It can be VERY helpful (I speak from experience - decided to stop antidepressants because of pregnancy, was offered therapy, and it helped a lot, specially because now I don't have the "cushion" of the meds - sometimes meds help, but in some other cases they just hamper the treatment of the real causes of the problem, hiding them).

Therapy is more expensive than meds, that's why consultants are quicker to offer drugs. But if you get good results from therapy (even if you don't have time to deal with all your problems), they will be longer lasting.

(I'm not saying drugs are not good, not at all!! But sometimes they are not enough)

weegie you are very kind - it's a lovely offer but i don't travel up til 3rd (we're going to relatives in perth)

ect is avaialable as consultant does do it but it's seems so very very scary

dodo what other sorts of therapy do you mean?

mamadoc - that does soound like what he was saying or trying to say but i just didn't hear that - according to my dh that happens alot

blushingm I was refering to different types of therapy that may be available through the NHS. The ones I know are: the short CBT (cognitive behavioural therapy), which is usually 6 sessions and deals with a specific problem (that can be quite helpful in some cases); the more traditional long term(ish) psychodinamics therapy, where you have individual sessions with a therapist for a longer period of time; and there are also group threrapies (that I never tried but heard that are offered in some cases).

Basically, all of them involve talking to a therapist about your issues and trying to find the reasons for your problems, but different types may be offered in different occasions to different people. I believe any of them would be useful in your case.

I suggested you did a good search on the NHS websites, learnt all about the options available in your area and then talked to your consultant.

Yes I found psychotherapy very helpful and did create long term improvements. Definately worth doing either with or without meds at the same time. I never found any meds that were helpful so dealing with the root causes was the best solution for me.

Change your consultant darling, he is not helping you.

Also agree with other posts, not your fault. You have come this far don't give up. There are still other meds to try and other therapies. Lifestyle changes if only to help take your mind off it for a few minutes each day are worth a try.

Feel for you. Good luck xx