Rexulti, Electroconvulsive Therapy, or Transcranial Magnetic Stimulation?

[anhedonia87]

Hello. Joined here a few days ago. I have treatment-resistant Major Depressive Disorder and Social/General anxiety.

I've been in therapy and tried so many different medications over the past 12 years for depression, but at least once every 3 months, I start feeling severely depressed. I can't get out of bed and I have to miss work.

With my most recent episode, my psychiatrist is wanting to add Rexulti. I'm currently on 20 mg Lexapro, 20 mg Adderall (prescribed off-label for depression and lethargy), and 4 mg Klonopin.

I don't tend to get my hopes up with new medications, because at best I only notice minuscule improvements. I'm trying to decide if I should go ahead with Electroconvulsive Therapy since it seems to be among the treatments with better success rates for depression. It sounds like that would put me out of work for at least 5 weeks, which would be worth it if it was a success, but at the same time makes me really anxious about all the work I'd have to miss. And I worry that it would all be for nothing if it doesn't work.

I've also been considering Transcranial Magnetic Stimulation. It seems like it might not have as great a likelihood of success as Electroconvulsive Therapy, but I'd be able to keep working, just missing a couple of hours a day during the treatment, and I wouldn't need to have someone with me 24/7 for the several weeks of Electroconvulsive Therapy. But if ECT has a better response rate, I don't know that it would be worth going the TMS route in the long run.

Has anyone had a similar background and had success with either Rexulti, TMS, or ECT?

[Hopeful-Tinkerbell]

I have not but I feel for you. I sometimes feel like I never find relief. At least good relief. I have better days then BAM something triggers massive anxiety and depression. I have to give you my opinion for what it’s worth which probably isn’t much. All treatments affect each individual differently. So others people may not be yours.

Example: my grandson has an illness. He was offered a minor procedure that may or may not work. My daughter in law decided she would rather him have the major surgery that had a much better success rate instead of the little one that probably wouldn’t work. So he had major surgery. It was horrible to see but we supported him. He’s pretty tough. Well it didn’t last 3 months. Then they had no choice but to do the little one and it has lasted 3 years and counting. Praise God. True story. I’ve also worked in the hospital icu most of my adult life I started nursing school in high school and also was on the rescue squad for several years I would never go straight to the last chance scenario without trying the least invasive or intrusive

So I have to recommend starting at the bottom and working your way up. Until you experience something you never know what will and will not help. Don’t put yourself out of for the major thing until you’ve tried the minor.

I truly hope you find the answers that work best for you. We’ll be here for support no matter what you decide.

[anhedonia87 in reply to Hopeful-Tinkerbell]

Thanks; I appreciate your perspective. Sometimes it's hard to imagine coming out of times when my mood has gotten very low, but it has always improved in the past. I just never know how long it will take. I guess I'll think of these as potential treatments for the future that would only be in a case where I'm worse. I have felt much worse before.

[Hopeful-Tinkerbell in reply to anhedonia87]

Trust in your proofs. You have always come out of it before. I have a proof journal for difficult situations like surgeries. I’ve had over 30. Not by choice and I hate it but I know I’ll get through it.

I don’t want you to think I’m saying do nothing. I’m not. Just start at the easiest (maybe the Med) and work your way up to the most intrusive ibecause you just don’t know how it will affect you. The easiest may work. It did for my grandson but he was put through major surgery first that didn’t work.

I’m here anytime. I try to check in regularly. I hope you get improvement soon. Until then we’re here for you no matter what choice you make. I was just telling you what happened to me with my grandson. The easier worked better.

[anhedonia87]

I talked to a therapist about when my depression started. This therapist talked to me about further back when it began. I got bullied a lot by other kids when I was little, but I hadn’t talked about a family member who bullied me a lot.

When I was in elementary school, it was doing a lot of things like making fun of me or pinning me down on the ground, which made me cry because I was claustrophobic. When I was 12 or 13, he started grabbing my butt and crotch, and reaching up my shirt and squeezing my chest. He was an adult and other adults saw but didn’t do anything about it. He was constantly humiliating me and making fun of everything about me. I know that so many people have gone through way worse things than that, so I’m not sure if it is one of the things that has caused my depression. I feel like it might have eroded my self-esteem and caused me to hate so many things about myself and my body. I had never talked about it or thought much about it until it came up in the therapy session. I’m not sure if this is one of the main contributing factors to my problems with depression. It’s making me so mad to think about. I am hard on myself and blame myself for everything, but looking back, I feel kind of sorry for myself now, like I’m not completely to blame. Maybe I’m just so frustrated with feeling so down all the time that I’m picking something arbitrary to direct my anger at. I don’t know what to think about it.