Posted by Amorphous on December 19, 2011, at 3:07:56
I'm looking for insight into an issue regarding the treatment of my depression, preferably from somebody with knowledge of treatment-resistant depression and neuroscience. If you don't possess such knowledge but are aware of a suitable place I may ask, I would be greatful for such knowledge.
Summed briefly, I have chronic, treatment-resistant major depression and generalised anxiety which has proven resistant against every form of treatment attempted including SSRIs, SNRIs, Tetracyclics, mood stabilisers, antipsychotics, electroconvulsive therapy and psychiatric therapy including CBT. Potentially, its severity is also increasing as I age.
While SSRI/SNRI medication has given me modest improvement, it has never improved my mood beyond dysthymia and after eight to ten months of use loses its effectiveness requiring me to switch to another medication.
The most significant issue lies with several anomalously positive improvements from a handful of medications when co-administered with the SSRI/SNRI (Lithium, Aripiprazole, Mianserin). After approximately a week of commencing the initial low dosage I experience a radical and profound improvement in my mood. I become brighter, livelier, socially engaged, cognitively capable and generally interested in life. Furthermore I become more physically capable, exercising well beyond my usual limited degree of strength and fatigue in addition to experiencing the endorphin rush that I had until this point, considered a myth. The great tragedy is that this state lasts only several days then rapidly ceases with no further recurrence regardless of increases to dosage or time.
I am now left with worsening depression and anxiety that alternates between dysthymia and severe anxious depression with suicide idealation becoming more common. At this point I fear that the only remaining possibility of successful treatment could be experimental and expensive deep brain stimulation.
Does anybody have any insight or suggestions regarding this profound but brief improvement I experience with certain medications and its similarly rapid cessation? Also, would this likely be detrimental to the success of DBS? My fear is that the mechanism by which my brain so rapidly adapts to medication could also mitigate any improvement gained through other therapies. I have been unable to gain any insight locally so am reaching out over the Internet for answers.
Thank you for your time.