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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Girlnterrupted78 on December 28, 2009, at 4:50:54
I was wondering, when you have treatment resistant depression and have tried pretty much everything, at what point do you stop trying and come to terms with the fact that your depression is pretty much untreatable?
I know some countries (I believe Holland) allows euthanasia for people with treatment resistant depression who have exhausted all forms of treatment.
But when do you reach that point where you tried already everything and can say you exhausted all treatment available to you? When and how do you know your depression is untreatable, at least by the current treatments available?
Has anyone reached this point, or feels close to?
Posted by manic666 on December 28, 2009, at 6:14:32
In reply to At what point do you stop trying + come to terms?, posted by Girlnterrupted78 on December 28, 2009, at 4:50:54
well i have tried every thing near on that england can offer, if your not rich,you get patial relief an then bang start again .its very soul distroying sure,but being dead is worse,my opinion if i get that close ,i have been once,do something crazy, i did with the litre of brandy an 10mg ativan, But you no for about 3 months it got me out the big hole, all be put me in a bigger one at the end ,ie hospital.but it broke op the pattern i was in ,in the three months i didnt give a sh*t,but i set a limit. an when i got there .Thats the bummer ,i could have gone on higher an in the end died.well mabye no my ativan supply ran out.but it gave me a break,now i had to face an even bigger battle an was close to looseing that.but i got through it. although it never leaves my head.so your question i do get partial relief , but i no what your saying ,even though i have a family . if it came to a what you saying , i would try another self medication tactic, i have done the booze an the high benzo rout. i would probibly go the illegal drug route for one last try at escape.wrong i know but im answering you question like you asked . not for anyone else to do or even try,thats the aswer to your question ,MMMMMe //now me i still believe there is a med for me ,so i battle on . and there is always a good or bad tactic to try , sometimes like me the bad tactic took me out of that bad place all be a short time, But long enough to face a new battle.an you carnt do that DEAD, stay safe
Posted by janejane on December 28, 2009, at 7:26:36
In reply to At what point do you stop trying + come to terms?, posted by Girlnterrupted78 on December 28, 2009, at 4:50:54
I don't know your background, and I know we are in the medication area, but have you looked into alternative treatments at all? That opened up a whole new world of possibilities for me, with seemingly endless things to try. Even in the pharm world, there are always new drugs coming out. Who knows maybe next year something will be approved that will do wonders for you.
Posted by Phillipa on December 28, 2009, at 11:01:14
In reply to Re: At what point do you stop trying + come to ter » Girlnterrupted78, posted by janejane on December 28, 2009, at 7:26:36
I know the feeling I just keep trudging on. Hard but do it anyway. You just have to fight. Phillipa
Posted by Nadezda on December 28, 2009, at 11:51:55
In reply to At what point do you stop trying + come to terms?, posted by Girlnterrupted78 on December 28, 2009, at 4:50:54
Never. Just never. There are always combinations that you haven't tried. Even if it's a terrible burden to deal with trying over and over.
And there will be new treatments.
You can't give up. And euthanasia for trd? No way. I can't imagine what the Dutch are doing, but that's just wrong.
You have to accept--that is, come to terms with-- the present reality and try to cope--and also be kind to yourself-- but you can't give up. There's too much possibility for the future. I spent most of my life (until the last three years) going through cycles of deeper and deeper depression before I found the right pdoc and combination.
It's just too important to believe in the possible-- even if it's not within reach now.
I don't mean to be harsh, but I can't accept anyone's giving up-- even though I've had my times, too-- and even now have moments.
I know you've been going through hard and disappointing experiences lately-- but your depression is not untreatable forever-- even if the latest attempts have been draining.
Nadezda
Posted by Phillipa on December 28, 2009, at 12:07:49
In reply to Re: At what point do you stop trying + come to terms?, posted by Nadezda on December 28, 2009, at 11:51:55
Excellent post. Phillipa and Nazenda is right.
Posted by manic666 on December 28, 2009, at 13:32:30
In reply to Re: At what point do you stop trying + come to terms?, posted by manic666 on December 28, 2009, at 6:14:32
yes thats the answer , never give up.i take things to the extreme to get out ,or sometimes get deeper in the sh*t. but i have lived with this all my life an am a complete nut job ,even i no it myself. but what ever mad thing i do, is my way of trying to change the pain im in.Not to die ,even though it may kill me. Im trying to survive , it puts my family on red alert. But hey im hear talking to you now.lots of people are in the same state at least we dont get bored. i keep up the fight ,so can you.
Posted by bleauberry on December 28, 2009, at 18:03:33
In reply to At what point do you stop trying + come to terms?, posted by Girlnterrupted78 on December 28, 2009, at 4:50:54
Well, for me, I come to terms right now in the present. I admit and accept I am not going to be the dream I want today, tomorrow, next week, or next month. But give up completely? No way. I come to terms right now to be realistic, because it helps me go forward. It allows me to focus on what I have and to work with that.
For example if I had a Porche, but it had a terrible engine banging and it leaked a quart of oil every 10 miles and I no one around knows how to work on a Porche and I can't drive it far away right now. Well, ok. I have to drive it careful. Go easy. I have to rest it a lot. I have to keep adding good oil. I have to pamper it. Someday I'll have enough money saved up to load it on a tow truck that can take it to a city where it will be fixed. But for now I have to accept what is and make the best of it. While everyone else is going 75mph on the highway, I'll be going 45mph. Not forever, but for today yes.
Some of the best music I've recorded was when I felt the worst. I force myself to play when I'm in bad shape. It is an escape, but it hands me gifts in return for the faith of sitting down to do it even though I would have rather just died.
So I accept today as it is. But, my eye IS on the future. Like you, I have exhausted so many options. Let's see, out of the entire universe, the only two I have not tried are Nardil or Effexor. I've done failed ECT.
But, you and I have to realize that there are so many different combinations and permutations of meds, there is no way we could possibly have tried them all.
Here's a real life example. A guy has been on all the drugs. His last choice is Nardil. It works a little and poops out fast. He returns to a former drug, Cymbalta. He had added a lot of things to it the last time he tried it, but not Wellbutrin. This time he adds Wellbutrin. It is a little better than Cymbalta alone, but he is still in bad shape. Then he adds Savella to it. Within 2 weeks he is in remission. He tries to wean off the Cymbalta, thinking it is Savella doing the magic, but he relapses, reintroduces Cymbalta back in. Tries to stop Wellbutrin, relapses, reintroduces. None of the drugs on their own, and no two of them on their own, did much. The three together were magic. And who would have ever figured? I mean, the combination involved combining two SNRIs. Admittedly only one is really a balanced SNRI, but still, you know what I mean.
I think when we get to this point we have to think outside the box. We cannot stick to common protocols. We cannot do what looks theoretically like it makes sense. We have to combine things that we never combined before. We have to get away from the whole diagnosis thing. Just try stuff and to hell with whatever some doctor calls it. Doesn't matter at this point. The diagnosis itself may be the problem preventing going the right path.
And all the while, we need to revisit the diagnosis. People get sick of me saying it, but it happens, and is worth knowing...my doctor says some of his Lyme patients present with only one symptom...depression...that is poorly responsive to meds. They instead respond very well to antibiotics for their depression. As another poster here commented on recently. I mean, I could go into several different topics here, but the general idea is...we HAVE to expand our world outside the psychiatrists office and creatively look for more information that was maybe missed along the way.
In the meantime, there are combinations you have not tried. Yeah? Personally I think it is a good rule of thumb to keep the maximum number of meds at any given time to three. Within that framework, the amount of different things we can try is amazing. And we cannot rule out a med because it didn't work before...it may well work like magic when it has the right partner(s).
Without even any idea of everything you've tried, was a combination with Savella on that list? Just curious. Doesn't mean anything, just curious.
You will get better. I can see it.
Posted by Meltingpot on December 29, 2009, at 10:32:42
In reply to At what point do you stop trying + come to terms?, posted by Girlnterrupted78 on December 28, 2009, at 4:50:54
Hi,
Over the last couple of years I have thought a lot about suicide. Sometimes I get into more of a state because I want so badly just to end my own consciousness but I just don't have that resolution. I've always been slightly in awe (and I know I shouldn't) of people who manage to simply go off and hang themselves. It must take an enourmous amount of comittment and resolution.
I've even written and have become a member of Dignitas but have found out that even if you are a member then you still have to get some kind of medical report from a psychiatrist saying that you are in a rational state of mind to make a decision to end your life. I feel this sort of report would be impossible to get hold of so I can't even draw comfort from an organisation such as Dignitas being able to help me.
Whilst I have Zyprexa (which does give me some relief) and whilst I have my mum around (who loves me to bits) I will carry on but who knows in the future.
I do believe that if a person with depression has tried everything (including VNS and DBS) and nothing is providing much relief then they should be able to have the option of ending their life in as humane way as possible with as little suffering as possible. I'm not saying that they should go ahead and do it straight away but the option should be there.
It annoys me when I hear people say "well if you are just suffering from depression then you have no right to kill yourself" who has the right to say this? As far as I'm concerned depression can seem like a terminal illness. What is acceptable to one person might not be acceptable to another person.
Denise
Posted by tiopenster on December 30, 2009, at 12:39:54
In reply to Re: At what point do you stop trying + come to terms?, posted by bleauberry on December 28, 2009, at 18:03:33
My problem is anxiety, fear, paranoia. I had similar feelings as you did, but not so dire. It took me 3 years, but I finally found something that worked. After 30 medications, I found a cocktail of 6 different meds that did the trick. I tried really hard to pair it down, but I had to have all 6. Sorry bleuberry, I would be out of luck if I limited it to 3. My lucky combination is Geodon, Neurontin, Lamictal, Depakote, Remeron and Lyrica. Don't ever give up and euthanasia should not be an option. You may be in pain, but you can still help others by living.
This is the end of the thread.
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