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So for seventeen years I've had pain depression.  It especially feels like it's squeezing my heart.  It hasn't historically been *about* anything.  I've just chalked it up to biochemistry, heredity.  And I've thought about suicide, most days, for at least fifteen years - because pain sucks.  Ups-and-downs.  Roller-coasters.  Probably every person on here has done time at the worst torture theme park in the world.

Two years ago, my cocktail started working.  There was some CBT and DBT in the mix too.  I decreased my daily Ativan from 3mg to 2mg.  Plus 20mg Latuda, 300mg Sertraline, 100mg Topamax.  I actually felt happy, for about two years, until this October.  Then it stopped working.  And I stopped working.  I work in a level I trauma center, where I identify cancer, anemia, and the effects of the coronavirus on the human body.  I feel like I have a front row seat to human suffering, without being empowered to ameliorate it, and it's another kind of torture.

I am very tired of fighting.  If there was a euthanasia travel agency, where I could just walk in, plan my funeral and end-of-life arrangements, plan my ideal death, and just call this thing at 38, that would be a somewhat attractive option (not telling, The Tallest Man on Earth, flaming-Viking-burial-at-sea.)  I'm tired of fighting this disease, personally.  And I'm tired of coming up against the tsunami of "world suck" (H/T Vlog Brothers) which seems to be hate-fucking itself ad astra.

So the strain theory, which I haven't read much on yet, is that we consider the termination of our lives when under one or more types of strain.  I personally find this theory hopeful, as targeting the sources of strain, i.e. "world stuck," could reduce the inducements to terminate one's life.  The General Strain Theory, according to one Wik I. Pedia cites loss of positive stimuli, addition of negative stimuli, or the inability to reach a desired goal, as three possible sources of strain.  I will follow up on this with my tdoc on Wednesday.  I think work is introducing negative stimuli, and I have a shit ton of unreached goals, but am starting to care about goals less and less.  Basically, it pisses me off that I've had to dramatically reduce my goals due to my diseases, and it's kind of tempting to just leave the party.  Please feel free to weigh in if you have personal and or academic experience with this.

I'm also meeting virtually with my pdoc tomorrow... to tweak the cocktail.  Would love recommendations.  My current rx mix, dxs and rx, failures are in my signature.  Lamictal induces hives and vomiting.  Depakote causes dyskinesia.  Lithium ruined the thyroid and causes acute renal failure.  Medicine.  Ha ha.  Organ roulette.

So the observation about different species of depression is that while for a decade-and-a-half I experienced what seemed like purely biochemical, chains-around-my-heart, tar-and-shark-filled, basements-beneath-basements depression.  This feels more like a rational(?) depression, which has me concerned about whether it will be responsive to biochemical therapy.

 

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Hi! I havent been here for a while. I just wanted to say hang in there. There is hope. I hit a very bad lengthy period myself. Tons of med failures and hopelessness........Switch doctors, again! and finally got with the right people(not saying your not with them!) and got things together. It was a LONG process, i was on a ton of medications as well. Regardless. There is hope, hang in there! Ask about past meds, being combined with other meds in different combinations(assuming it wasnt crazy side effects why you stopped).

 

The one thing I felt like mentioning....is I have migraines myself.....so I noticed the Ajovy, immitrex, Topamax, Riboflavin, magnesium which I assume are all for migraines.......Have you ever considered a TCA such as nortriptyline or amitryptiline(spelling may be off). I know they are used for migraine treatments very commonly, and fairly effectively. I have also heard some decent success with TCA's for depression as well. Perhaps some help with both the migraines and depression? Regardless, stay strong!

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3 hours ago, Inanlae said:

So for seventeen years I've had pain depression.  It especially feels like it's squeezing my heart.  It hasn't historically been *about* anything.  I've just chalked it up to biochemistry, heredity.  And I've thought about suicide, most days, for at least fifteen years - because pain sucks.  Ups-and-downs.  Roller-coasters.  Probably every person on here has done time at the worst torture theme park in the world.

Two years ago, my cocktail started working.  There was some CBT and DBT in the mix too.  I decreased my daily Ativan from 3mg to 2mg.  Plus 20mg Latuda, 300mg Sertraline, 100mg Topamax.  I actually felt happy, for about two years, until this October.  Then it stopped working.  And I stopped working.  I work in a level I trauma center, where I identify cancer, anemia, and the effects of the coronavirus on the human body.  I feel like I have a front row seat to human suffering, without being empowered to ameliorate it, and it's another kind of torture.

I am very tired of fighting.  If there was a euthanasia travel agency, where I could just walk in, plan my funeral and end-of-life arrangements, plan my ideal death, and just call this thing at 38, that would be a somewhat attractive option (not telling, The Tallest Man on Earth, flaming-Viking-burial-at-sea.)  I'm tired of fighting this disease, personally.  And I'm tired of coming up against the tsunami of "world suck" (H/T Vlog Brothers) which seems to be hate-fucking itself ad astra.

So the strain theory, which I haven't read much on yet, is that we consider the termination of our lives when under one or more types of strain.  I personally find this theory hopeful, as targeting the sources of strain, i.e. "world stuck," could reduce the inducements to terminate one's life.  The General Strain Theory, according to one Wik I. Pedia cites loss of positive stimuli, addition of negative stimuli, or the inability to reach a desired goal, as three possible sources of strain.  I will follow up on this with my tdoc on Wednesday.  I think work is introducing negative stimuli, and I have a shit ton of unreached goals, but am starting to care about goals less and less.  Basically, it pisses me off that I've had to dramatically reduce my goals due to my diseases, and it's kind of tempting to just leave the party.  Please feel free to weigh in if you have personal and or academic experience with this.

I'm also meeting virtually with my pdoc tomorrow... to tweak the cocktail.  Would love recommendations.  My current rx mix, dxs and rx, failures are in my signature.  Lamictal induces hives and vomiting.  Depakote causes dyskinesia.  Lithium ruined the thyroid and causes acute renal failure.  Medicine.  Ha ha.  Organ roulette.

So the observation about different species of depression is that while for a decade-and-a-half I experienced what seemed like purely biochemical, chains-around-my-heart, tar-and-shark-filled, basements-beneath-basements depression.  This feels more like a rational(?) depression, which has me concerned about whether it will be responsive to biochemical therapy.

 

has increasing the latuda ever come up? you have tons of room, although it is true that more isnt necessarily better for depression in some people. I ask because doc might want a "fair trial" before ditching a previously helpful med. If you do end up in the market for a switch, rexulti might make sense. As far as the sertraline- 300 mg is high (as i am sure u know already)... do you think it would be worth a cross taper to a different AD? trintellix can be activating, but maybe not as good for anxiety (*to whom it may concern: I understand that the pharmacology may not totally support this swap, I am just thinking of possible ideas different from what OP has already tried.) ... however, i know there can be interactions between migraine meds and psych meds and I won't pretend that Im an expert in that area (or any area) so im not gonna say anything specific about the antidepressants for fear of suggesting something colossally stupid 

i think @looking for answers has an interesting idea as well. Even if it doesnt happen, might be interesting to see what your pdoc would think of that strategy. 

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Thanks for the feedback, folks.  We're going to try adding Trintellix (same as Brintellix), and I'm going to enroll in an intensive outpatient therapy program (again).  It helped last time.  My short term disability administer is giving me an extension too.  Virtual paperwork is difficult, and doctors get sick too (the best doctors, anyway--they're the best because they've been sick; they don't get sick because they're the best).

None of this would be possible without health insurance.  Failure to insure all people everywhere is the height of inhumanity.  The brilliant Catch-22 of privatized health insurance and working:  you have to work to get health insurance in order to be healthy enough to work.

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10 hours ago, Inanlae said:

Thanks for the feedback, folks.  We're going to try adding Trintellix (same as Brintellix), and I'm going to enroll in an intensive outpatient therapy program (again).  It helped last time.  My short term disability administer is giving me an extension too.  Virtual paperwork is difficult, and doctors get sick too (the best doctors, anyway--they're the best because they've been sick; they don't get sick because they're the best).

None of this would be possible without health insurance.  Failure to insure all people everywhere is the height of inhumanity.  The brilliant Catch-22 of privatized health insurance and working:  you have to work to get health insurance in order to be healthy enough to work. 

glad to you hear you have a plan and got some help! hope it all works for you. FWIW ive taken trintellix in the past, i liked it. I know a few that have! Glad you have insurance and have some things going your way. Stay healthy.

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