Treatment resistant depression

[Sad57]

This is my first post so I'll write only the basics. Over the last 10 years I've tried 15-20 different antidepressants from all categories for my: Chronic Depression, Anxiety and PTSD. As none of them worked, last year I was diagnosed with TRD. I'm seeing my Psychiatrist and GP on the regular basis. Thanks to one "of the label" medication I am able to get uo in the morning and do some basic chores. I'm talking about 3-4 hours window. The rest of the day I spend in bed. Is there anything new in the medical field?  I read about some nasal sprays which is apparently helpful but it's extremely expensive and not affordable for people like me. Any info would be much appreciated. 

[Sad57]

Thanks a lot for the advice and detailed info. All the best! 

[sbella02]

I'm sorry to hear that you've had this experience, and I can see how it would leave a sour taste when wanting to seek professional help in the future. 

I agree with what Eagle Ray has said, particularly about treating it like a quest. I would also suggest potentially looking into different kinds of therapy that may help to alleviate some of the more prominent symptoms. There are some therapy programs that can be really good for helping with sleep, for instance. 

To echo Eagle Ray, second, third, and even fourth opinions can also be really useful. Every professional has slightly different experiences with regards to treating different conditions and symptoms, and sometimes you come across somebody who'll be able to help in a way that you haven't tried before. It's worth looking around, if you're able to. 🙂

[Sad57]

It's hard to communicate on this forum when we're not allowed to mention any medication. I also did some research and certain meds that helps me get out of bed in the morning was my idea. Fortunately the Government approved it for the last 2 years. Regarding exercise and spiritual healing, that's the Cach 22. You need them to feel better but you can't do it because of lack of motivation and energy. 

[Sad57]

There's a certain Nasal Spray on the market which apparently works wanders for TRD. The only problem is that it's not subsidised by Medicare and the monthly cost of treatment is around $3000. I can't afford that. 

[Eagle Ray]

Hi Sad57 and wave to sbella 👋

I think I know the spray you are referring to and, yes, that line of therapy is very expensive and out of reach for many. As far as spiritual healing goes, I’ve managed to do some of this working with altered consciousness states without the aid of any substances, plant medicines etc. I seem to go into altered states quite easily, perhaps because I’ve always been dissociative. I've done some sound healing over a few years that definitely took me on some journeys. I've also had someone sing to me from the Shipibo shamanic tradition that lead to some profound shifts at a mind/body/spirit level. It can be a little challenging to maintain these kinds of shifts after they happen, but it all adds incrementally to the mind/body/spirit complex learning and knowing that healing is possible.

When I first arrived where I live now my mental and physical health really collapsed, but some days I managed to drive 10 minutes out to a seaside location. I've found a rocky hill there where I feel really spiritually connected. Often I've only just had the energy to sit there, but it is like the place has held me when I felt completely alone. I feel like at times I've gone into altered states there and a lot of spontaneous healing kind of just happened. It's not that it solved everything, but it has been a place where I have felt safe enough to let difficult emotions arise, be felt and let go of. For me, anyway, depression is emotion trapped and locked down in the body. It has to feel safe for that emotion to come out. While it is still trapped in me I stay in a freeze state. It can hurt when it's coming out and I've cried a lot of tears on that rocky hill, but it always feels better afterwards. Early on, when no one else was around, I've also screamed into the wind there. It has helped and it has been a constant source of safety and stability when so many other things were not stable for me.

I'm wondering if there are any nature places you feel connected with, or just any space that feels safe for you? Also, I can recommend calling helplines if you are ever feeling isolated or just would like someone to talk to. I have found it can sometimes help to at least partially shift how I'm feeling. I've found if the first person I speak to isn't the right fit, it is worth giving it another go and the next person is often just the right person to speak with. If you are looking for one with a good understanding of PTSD, The Blue Knot Foundation specialise in Complex PTSD, but I think would chat to you even if your PTSD is not of the Complex type. Their number is 1300 657 380 (7 days a week, 9-5 eastern states time). Beyond Blue, Lifeline etc are all there to support you too. I have called them all at various times.

I guess what has helped me turn a corner has been many individual things which added up together have made a difference. I also found that I was increasingly hormonally dysregulated too in the later stages of perimenopause, and being medicated for that with hormone medication has made a profound difference in relation to debilitating anxiety and depression. I don't know your age or gender, but it may be another thing to think about if you think that may be a factor.

Anyway, just some more thoughts. Take good care and we are here if you need a chat anytime or just need to express how you are feeling.

[Eagle Ray]

Hi Sad57,

In the last few days I've learned about the role histamine intolerance can play in treatment resistant depression. I have been experiencing severe histamine intolerance for many months now though it's beginning to improve. I'm also dealing with depression. I've only just found out that the mainline antidepressants (cannot name specifically unfortunately) can fail to work in people with histamine intolerance. As histamine intolerance is not well understood in the medical profession, a lot of doctors are probably unaware of that, but there are clinical studies and medical journal articles on the topic. Currently I'm working with a naturopath to calm mast cell activation in my body and reduce histamine.

None of that may be relevant to you, but just in case it is related to your resistance to antidepressants working, I thought I would mention it as another possible avenue to look into. It's related to the interplay between histamine and serotonin. If you have significant histamine intolerance you would probably know in that you would have things like an ongoing post nasal drip, reactions to certain foods or possibly hives, dizziness, gastro disturbances etc. Sometimes there are logical biological reasons why something isn't working but it's just not something well understood medically yet.

I hope things may have improved for you in the last few months.

Best wishes,

ER