Treatment Resistant Depression

So… at the end it says there are many options to explore to help treatment-resistant depression, but doesn’t list any of them. 🤨

https://www.amazon.com/%C4%B0zzet-G%C3%BCll%C3%BC/e/B07SD69NPX

If these options were so readily available I would have found them a long time ago. I have done everything conceivable to no effect. That's what treatment RESISTANT means…. no options have any effect on it.

When my psychiatrist told me I had treatment resistant depression my heart broke morr

"2:23" This is glorious, thanks, I am interested in your thoughts.
I have been researching "herbal remedies for depression anxiety" for a while now, and I think this has helped. You ever tried – Tarbally Destroy Depression Tactics ?
Go to 𝗱𝗲𝗹𝗲𝘁𝗲𝗱𝗲𝗽𝗿𝗲𝘀𝘀𝗶𝗼𝗻 .𝗰𝗼𝗺 (remove spaces)
It is an awesome one of a kind product guide for beating depression minus the normal expense. Ive heard some awesome things about it and my work buddy got great success with it

A whole lot of nothing. Thanks

I have zero qualifications in medicine, psychiatry, or pharmacology. So what I’m about to say, do not take it as gospel. It’s merely a speculation. A lot of what I say below may be completely inaccurate or untrue.
This is simply my own hypothesis from 13 years of personally trying countless treatments, as well as researching a lot of scientific articles from NCBI.

Based on all my experience, and all the scientific articles I’ve read, here are what I believe to be the potential reasons for a patient failing to respond to depression treatment.

1. You may have an underlying physical condition which is causing depression as a side effect. Examples: Hypothyroidism, Hypogonadism, and Hypercortisolism (although the latter is quite rare and there would be clear physical signs visible also). For this reason, it’s always a good idea to get a complete medical examination (blood tests, urine tests) to ensure there is no underlying physical issue.

2. Your depression might actually be Bipolar Disorder, where the symptoms can be made worse by antidepressants as they can cause rapid cycling of moods. Interestingly, for a lot of patients, their Bipolar Disorder may not become apparent until they’ve been put on meds for Unipolar Depression.

3. You may have comorbid conditions alongside your depression which need treatment separately, or else they may exacerbate your depression or hinder treatment efficacy. Eg. ADHD, Autism, Borderline Personality Disorder.

4. You may have Seasonal Affective Disorder which is brought on by lack of sunlight. This would need treatment in itself (eg. SAD lamps).

5. If your SSRI isn’t working, you may be on the wrong SSRI. As an example, some SSRIs may have limited entry to the brain by an enzyme called P-Glycoprotein (aka. Multi Resistance Drug Protein). If you have a strong version of this enzyme, you may fail to respond to antidepressants that are affected by it (eg. Escitalopram). Thankfully there are other antidepressants that aren’t affected by it (eg. Fluoxetine).

6. You may respond better to antidepressants that boost both Serotonin and Norepinephrine (eg. Duloxetine).

7. You may respond better to the oldschool Tricyclic antidepressants (eg. Imipramine) which act through multiple pathways. However, the side effects with these can be more severe.

8. You may respond well to a unique type of antidepressant called MAOI (= Monoamine Oxidase Inhibitors). These are rarely prescribed as they can cause serious health issues, possibly even death, if combine with certain other drugs (anything that increases serotonin, norepinephrine or dopamine) or if you eat certain foods that are high in a chemical called Tyramine (eg. Cheese, red wine, fermented foods, aged/cured meats). That said, there is a newer MAOI called Moclobemide which leaves the brain much faster than the older ones (literally within 24 hours, whereas the effects of the older ones can persist for weeks). Sadly, Moclobemide is hard to find outside Europe.

9. You may respond well by augmenting your antidepressant with a special type of antidepressant called Mirtazapine, which blocks certain autoreceptors, thus enhancing the release of serotonin and norepinephrine and possibly dopamine to certain extent. Also, it blocks several Serotonin receptors (ie. “Bad receptors) which cause anxiety or bad mood when active. The drug has been shown to greatly reduce levels of the stress hormone Cortisol after even the first dose.

10. You may benefit by augmenting your primary antidepressant with a special type of atypical antipsychotic called Amisulpride, which at low doses blocks Dopamine autoreceptors, thus enhancing its release. It also is one of the few drugs to block the Serotonin-7 receptor, which may be another one of the “bad receptors” as it has been implicated in causing anxiety & mood issues when activated.

11. You may benefit by augmenting your primary antidepressant with several other types of atypical antipsychotics (of which the ones I believe are medically approved are: Olanzapine, Quetiapine, and Aripiprazole).

12. You may benefit by augmenting your primary antidepressant with Lithium. Typically this is used for Bipolar Disorder, but studies have shown it may also be effective for certain patients with Unipolar Depression. Note however you’ll likely need frequent medical tests/monitoring as the drug can be toxic above a certain threshold.

13. You may respond well by using a novel antidepressant called Agomelatine, either by itself or in combination with your primary antidepressant. This drug is unique in that it acts on Melatonin receptors.

14. You may respond well by augmenting your primary antidepressant with a drug that boosts dopamine, eg. Bupropion and Methylphenidate. Note however that Bupropion’s effect on dopamine may be modest at best, and Methylphenidate is only officially licensed for ADHD (so using it for depression would be “off label” under the care of a specialist).

15. You may respond well to the newly approved antidepressant Ketamine, which appears to be rapid-acting and has a unique mechanism of action. However the drug is quite hard to come by and can be expensive.

16. (Theory only at this stage) you may respond well to drugs that block a specific opioid receptor called the Kappa-opioid receptor. But as I said before, this is purely in its experimental stage at the moment.

17. You may respond better to treatment in general by taking a high quality multivitamin along with an Omega 3/Onega 6 oil supplement.

18. You may respond better to treatment in general by taking a special type of supplement called “methyl-donor”. These include: Methylfolate, MethylB12, SAM-e (S-Adenosylmethionine), and TMG (Trimethylglycine).

19. You may respond better to treatment in general by eating a diet completely free of of Casein (found in dairy/cow’s meat) and Gluten (found in wheat, bread, barley and rye). These 2 types of food have been cited as the biggest culprits in causing inflammation in the gut & the brain in susceptible individuals, even if you don’t have a classic allergy to them or don’t have Celiac Disease.

20. You may respond better to treatment in general by doing frequent aerobic physical exercise.

—
I say again, I AM NOT A QUALIFIED MEDICAL EXPERT. There is no substitution for consulting a trained and experienced professional.

Bs

That’s all good and well if you have the financial resources to spend on Dr’s and medications. And to pay for psychologist . But when you are struggling to pay your existing bills . And you already don’t drink smoke or have a social life ….where am I going to get the money to pay for this help ? 🤯 . Iv been dealing with this T.R.depression for decades ….in the past when it gets to critical mass I’ve , gotten help ….but that has depleted what little funds I had . Now my mortgage gets bigger by the day . And the family pressures are crushing Us . So what’s Your suggestion now ? 🤨 . These airyfairy advertising things are so bloody frustrating . You can find help if you have the money …. Less and less of us have the money day bye day . NOW WHAT ?? In Australia the medical system is linked to the insurance data base …. When I let my life insurance lapse because I couldn’t afford to renew it …. Then tried to get another life insurance policy a few months ago .my premium,s were going to be more expensive because of my mental health records. So now I still can’t afford life insurance. GREAT 🤨🤯 now if something happens to me my family has nothing 🤯 . HOW CAN I FIX THAT ? 💰💰💰💰💰🤨.

I have a problem with long-term depression and already take a high level of lithium. Is there anything that I could suggest? It's not good that I m resistant to common antidepressants.

I also have treatment resistant depression and I've tried one thing and it works: microdosing magic mushrooms at 0.1 g or 0.15g every other day and a two week break once every two months or so. It forces you to deal with your intense emotions (like I cry for thirty mins sometimes) and then you feel good and peaceful.

Depression can feel isolating, but remember that you're not alone. Seek support and consider treatments like [planet ayurveda].