# What are you supposed to do....



## Rosa (Jan 9, 2008)

when treatment for depression doesn't work?  Emontions have no place in this arguement, I'm thinking in terms of quality of life.  I have been in therapy for years with what I consider an exceptional doctor.  I no longer work with him as of this week.  I've tried about every anti-depressant out there.  I refuse to get electric shock therapy.  For those that know me, I have a home for my dogs so that is not an issue.  I would rather live a good week than to live years with this depression. 
Rosa


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## Into The Light (Jan 9, 2008)

*Re: What are you suppose to do....*

why are you no longer working with this doctor?

also, have you tried a combination of meds? i remember there was an article here at one point about using combinations of two anti-depressants instead of one for severe cases.

you say you have a home for your dogs, it sounds to me like you are preparing for suicide. am i misinterpreting?


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## Daniel (Jan 9, 2008)

Rosa, 

When I was most depressed, disillusioned, and most at risk for suicide, I found therapy did help calm me down and I'm sure it reduced the severity and frequency of my suicide attempts.   I did try ECT but it, apparently, didn't work for me.   

How long have you had depression?  Personally, I have had depression since 1995 when I was a senior in high school.   It has only been in the last couple years that I have stopped thinking about suicide very seriously for much of the time.  Regarding treatment, I benefit most from therapy + socialization  + exercise.  What triggers suicidal thoughts for me is stress and loneliness.   



> ...I'm thinking in terms of quality of life.



I have said the same thing to my therapist.  However, after reading the book _The Suicidal Mind_, I started thinking less in terms of quality of life and more in terms of frustrated psychological needs, specifically regarding, in my case, socialization.  ("It's the loneliness that's the killer.")  Three years ago I moved to be closer to my family and that has helped a lot.


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## David Baxter PhD (Jan 9, 2008)

There are many options for people for whom antidepressants "don't work" besides ECT, Rosa.

Sometimes, using a combination of medications is the answer. For example, you might with your doctor's help identify the SSRI that worked best for you, lower the dose a bit, add in a small amount of Wellbutrin and/or a low dose of one of the so-called "atypical anti-psychotics" (I know it's a horrible name but we're talking about a very low dose, not the doses used for psychotic illnesses - what they do is boost the effectiveness of the SSRIs).

I don't know if your doctor is a GP or a psychiatrist. If you haven't had a consultation with a psychiatrist, ask for one, specifying that you want someone who is an expert in psychopharmacology.


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## Rosa (Jan 10, 2008)

Thanks for your replys. I can't say I'm ok.  The depression has gone on and off for years and years.  Recently its just out of control. I've tried what has to be almost all the drugs out there for depression and in all kinds of combinations.  This is an especially stressful time for me and I'm sure that has alot to do with it but its a stress that I don't think I can handle much more.  Don't mean to be a downer. My doctor is a psychitrist and I've worked with him for years now.  I did agree yesterday to meet one more time with him. I'll see how that goes.  Honestly though, I really need some relief. 
Rosa


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## Retired (Jan 10, 2008)

Rosa



> I did agree yesterday to meet one more time with him



Is the choice to stop seeing this particular psychiatrist yours or is it due to some other factor?



> you say you have a home for your dogs, it sounds to me like you are preparing for suicide



I would like to echo this question.  If you are thinking about suicide, you need to keep yourself safe until you see the doctor again, and reprt these thoughts.

As the others have said, there are options available, as depression is treatable.



> I refuse to get electric shock therapy



What is your objection to considering electoconvulsive therapy?


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## Halo (Jan 10, 2008)

Rosa,

I personally can relate to pretty much all of what you wrote. I am glad that you have agreed to see your psychiatrist at least for one more session.  Does he know that you are not doing well and thinking in terms of suicide?  I know that you mentioned ECT earlier in your post and was wondering if there are reasons that you don't want to go that route?

Again, I can relate to what you are saying and I can only offer my support and lots of hugs :hug: :hug: :hug:

Take care :heart:


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## Mari (Jan 10, 2008)

Dear Rosa,



> I have a home for my dogs



Your dogs look lovely. My understanding of shepherds is that they are very loyal dogs. I can not imagine that they would be happy with any other owner. Our black retriever cried and sulked if we even left her for a few hours. Once we left her at a kennel for a few days. She opened three gates in order to get out and find us. The kennel owner changed her name to Houdini. Their home is with you. Please do not give up hope. :heart: Mari


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## Daniel (Jan 10, 2008)

> This is an especially stressful time for me and I'm sure that has alot to do with it but its a stress that I don't think I can handle much more.



There's always hospitalization.   Other than that, seeing a therapist two or three times a week can help.       (Also, when I have been on antidepressants that are known for being sedating like Remeron, I felt, at the time, that I was too tired to kill myself.)

Regarding ECT, a new book about it came out last year regarding ECT's comeback:



> In fact, the U.S. surgeon general and the National Institutes of Health agree that for severe depression ECT is safe, and often more effective than antidepressants or psychotherapy.
> 
> Shock: The Healing Power of Electroconvulsive Therapy By Kitty Dukakis, Larry Tye - Google Books



Needless to say, ECT is safe and suicide is risky.   (A signifcant percentage of suicide attempts result in full-body paralysis.)   I was able to take final exams while having ECT.  It wasn't a big deal.


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## Rosa (Jan 10, 2008)

I'm sorry I'm having such a hard time writing...I keep breaking down in tears everytime I come here. I go see my doctor in two hours and I will make him aware of how bad things are right  now.  I just can't handle the stress, the shaking, the feelings of being sooooo overwhelmed, etc much longer.  Yes, I have my dogs.  They have kept me alive this long.  I think seeing their pic by my name is hard because I know what they mean to me...more tears....
Rosa


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## Retired (Jan 10, 2008)

Rosa,

When considering therapeutic options, including ECT, to which you say you have reservations, you and your doctor will be weighing the benefits vs the risks of each option available to you.

You may have apprehensions about some modes of therapy, but ask your doctor to explain each of your options on a benefits vs risks basis.

This is the sensible (and scientific) manner in which you can come to an intelligent decision as to what will be best for you.

Your medical history is an important part of the equation which is why you need to have this conversation with your doctor.

When you and your doctor find the strategy where the benefits outweigh the potential risks, then this is the one to consider.

You need not feel this way, because depression is a treatable illness.  Sometimes it takes a few trials to find the therapy that will work for you.


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## David Baxter PhD (Jan 10, 2008)

Please come back and tell us how that appointment went, Rosa.


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## poohbear (Jan 10, 2008)

I also think that the reference to your dogs having a home could be a "foreshadowing" of some sort.  You sound very sad and I think you may feel as if you have no other option.  But you do!  You mentioned them in your post! (medicines, ECT and your therapist)  You can think of how long you've fought and how wonderful it will be to feel "good" again.  You only have to keep trying.

I think there might be a stigma attached to ECT.  People sometimes think of it as "shock therapy" and make a horrid little picture in thier minds of the process.  In actuality, it's done in a very clinical environment, much like any doctor's office visit.  It's not likely that anyone will "know" you've received treatments, so there shouldn't be any shame or fear about taking the treatments.  

Has your doctor suggestd this treatment?  I'm just wondering because in your post, you didn't say, except to say you think you've exhausted all medicinal avenues.  On that note, I think you may be frustrated you've not found the proper drug or combination of such to relieve your symptoms.  
Also, the ECT could be just the ticket you are looking for, at least for the short term.  Please look into it, online even.  There are a multitude of sites and research studies performed on this therapy (and in conjunction with the proper medication).  You could be just a click away (literally) from happier times.

I do hope you feel better about your options after your visit today.  Please continue talking your feelings out.


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## Retired (Jan 10, 2008)

> I think there might be a stigma attached to ECT.



You are quite right, and great strides have been made in this form of treatment in recent years.

Some insights into ECT can be found this Psychlinks posting


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## HA (Jan 10, 2008)

Hope you are okay, Rosa.

:grouphug:


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## Rosa (Jan 11, 2008)

Thanks for everyones kind words and support.  I will try to write but need to let you know I still start crying and am unable to stop...being at work right now that makes it hard.   I did see the doctor yesterday.  It went ok.  He put me back on the Abilify so hopefully that will help.  Emontionally I feel like my nerves are shot.  I shake all the time, I feel completely overwhelmed, I cry all the time. I can't think right.  I love my dogs more than anything on earth and believe they are gifts from G-d.  I will write more when I get better control of myself. 
Rosa


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## Retired (Jan 11, 2008)

> I love my dogs more than anything on earth and believe they are gifts from G-d.



Continue to focus on these as your reasons to live, Rosa.

We'll be eager to continue hearing about your progress.

Glad to hear you were satisfied with your doctor appointment.


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## Halo (Jan 11, 2008)

Rosa,

I am glad to hear that you went to your appointment and that you have made a medication switch.  I really hope with all my heart that it works for you.  I really do :heart:  I know that it is frustrating when medications don't seem to be working and you feel like you have tried them all trust me I have and am there.  But, we have to hang onto hope that one day we will hit upon the right combination of meds and we will be glad that we held on.  You have to hang onto the hope Rosa...there is hope with the right combo maybe just being right around the corner.

Take care
:hug: :hug:


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## Rosa (Jan 13, 2008)

Thank you all so much.  I've been back on the Abilify for several days now and I'm finally calming down.  I really appreciate your support and I'm really thankful Dr Baxter put up my pics of my dogs by my name.  Believe it or not, that made a difference.  These are my furcrew and what keeps me alive.  I do get frustrated in that I've been in therapy for years and been on so many medications and yet I'm still fighting the depression.  But I guess I'm not alone in this frustration.  I'm going to try spending more time here again, I think it will be good for me.  Part of the problem  with the depression is its like a cycle.  As some of you may recall I've had alot of trouble making ends meet.  Well when I get depressed I'm sometimes unable to work and I don't get paid for days off (no paid time off where I work) so that just makes it worse and it kind of feeds into itself. 
But all who said to focus on my dogs-you are right.  I did have a place for them but no matter how good it would be there-its nothing like the love I have for them.  They are kind of odd in the fact they think they have the greatest mom in the world! LOL..
Thanks again, and I won't be such a stranger next time. 
Rosa


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## David Baxter PhD (Jan 13, 2008)

I'm really happy to hear that you're feeling a little better, Rosa.


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## Into The Light (Jan 13, 2008)

it's good to hear from you again. i too am glad you are feeling a little better.


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## Halo (Jan 13, 2008)

I too am glad that you are starting to feel a little better and also that you are going to hang out with us on here more...great to have you back


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## Retired (Jan 13, 2008)

Good for you Rosa!  Glad to hear you are feeling better.

Please keep us posted on how it goes.


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## Rosa (Jan 15, 2008)

I'm doing a bit better today. I guess the meds are starting to work.  The Abilify can make me tired but it does slow my thoughts down and that has helped.  I just don't understand what causes those suicidal thoughts...obsessions if you will..... why I get so overwhelmed with thoughts of killing myself.  Friends this is so scarey, when you can't even trust yourself to keep yourself safe-what then? I know, there are places (such as hospitals) to go to, but that in itself doesn't change anything.  It might give you the time you need to get over the thoughts this time, but in all likelyhood if faced with this I would likely lie to everyone involved just to get myself out of there-then I'd even be in a worse place (more medical bills).  For the most part I am completely (or mostly) normal, but then there are these times if people knew what I was thinking they would be blown away. Oh well, glad to be back and sending hugs to everyone!!
Rosa


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## ladylore (Jan 15, 2008)

I am glad you are doing better.

I lived with suidical thoughts for many years. Even though I was rarely ready to act on those thoughts they did provide me with a choice. If the pain got too bad I could have a way out.

Those thoughts haven't occured to me in over a year. I have a whole list of other options besides suicide as it isn't an option anymore. I am glad things have changed and I thank my lucky stars that I have kept going as things have changed.

Glad you have chosen to keep going too. Just keep talking.

:hug:


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## David Baxter PhD (Jan 15, 2008)

I'm glad you're back, too, Rosa.


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## Holly (Jan 15, 2008)

Hi Rosa,
Glad to read your feeling a bit better, take care.


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## Cat Dancer (Jan 15, 2008)

Glad you're feeling a little better. 

I can relate to being terrified of having those scary thoughts and feelings about suicide. I have been struggling with this too and it's so scary. 

Take care of yourself. You deserve good things.


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## Rosa (Jan 15, 2008)

It is very scary, my biggest fear is that some day it will just be too much and I'm going to act on it-it can be pretty hard when you can't even trust yourself at times.  

Thankfully, though, I am feeling better.  I'm thinking as long as I have those dogs theres no way I'm going to kill myself.  They are the closest thing I've ever had to family and I don't want to do anything to take that away. 

Rosa


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## Retired (Jan 15, 2008)

> It is very scary, my biggest fear is that some day it will just be too much and I'm going to act on it



Rosa,

You must not get ahead of yourself, and become fearful of what _might_ happen.  We cannot make a plan for what _might_ happen, because we don't have enough facts about future, potential situations.  

Lets face it, if we had to have a plan in place for every potential future happening, it would be overwhelming at best and largely impossible.

We can only deal with what is occurring in our lives at the moment.

And because your mood and state of mind are in balance these days, as you report you do not feel at risk.

With the help of the health professional with whom you consult and the support of your friends and family, you can hope to remain in your current state.

If that state happens to change, and you feel at risk, make use of the resources available to you, your doctor, therapist, friends and family to help get you back to the state you now enjoy.

Deal with situations as they occur, and try not to speculate on what might be in the future.


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## lallieth (Jan 15, 2008)

Hi Rosa

Your dogs are lovely and I am glad you are feeling better.I agree with Steve,in that,you must not allow yourself to get caught in "projection" thinking.We can't predict what will happen in the future

Do you know how your dogs live Rosa? have you given it any thought.
Dogs live in the NOW..in the moment.
They have no care for the past or the future,but what happens to them each single moment.
They live each moment like their last,happy & content just to "be"

They have no idea when the next walk or treat will come,but boy,watch them when it does come..their bodies go into full excited wiggle mode,and their faces light up with pure joy

Watch your dogs for a few moments each day,watch them sleep in pure contentment,chasing elusive rabbits in their dreams,watch them play and interact,bouncing,play growling,full of joy and life...

We should all live our lives like dogs..living for the moment IN the moment,must be pure bliss.


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## ladylore (Jan 16, 2008)

Lets hear it for the dogs! :thewave:


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## Rosa (Jan 16, 2008)

ladylore said:


> Lets hear it for the dogs! :thewave:



Your too cute!!!! Thanks. There is a problem that has arisen.  The Abilify I think is causing my blood sugar levels to skyrocket.  Since I've been back on it (I didn't really check my levels when I was on it before...I know, bad me) but but since going back on it every morning my sugar levels are out of control.  This morning I got my highest reading ever of 148 and thats fasting.  I'm really not sure what to do. I know I will have to disclose this to my doctor which will also mean disclosing the fact that I didn't check it before....gee...I just can't win here.  
Rosa 
but your all right about my dogs....as you can see in their pic, they are a wonderful family to me!!!


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## ladylore (Jan 16, 2008)

I personally have no knowledge with the medication Abilify so telling your doctor would be a good thing and yes probably not checking your blood too. I don't think your the first person who hasn't checked their blood sugar levels on a regular basis. Your doctor has probably heard it before.  But I would definitely make an appointment as soon as you can to make sure everything is alright.


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## Halo (Jan 16, 2008)

I agree with Ladylore...making an appointment with your doctor sooner rather than later would be best especially if the medication is causing your blood sugar levels to go up that significantly.  Its true Rosa...I am sure that the doctor has heard it all before but the a positive thing about this is that he will see that you are checking it this time and really trying to take care of yourself now 

Good luck and let us know how it goes :hug:


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## lallieth (Jan 16, 2008)

Rosa said:


> Your too cute!!!! Thanks. There is a problem that has arisen.  The Abilify I think is causing my blood sugar levels to skyrocket.  Since I've been back on it (I didn't really check my levels when I was on it before...I know, bad me) but but since going back on it every morning my sugar levels are out of control.  This morning I got my highest reading ever of 148 and thats fasting.  I'm really not sure what to do. I know I will have to disclose this to my doctor which will also mean disclosing the fact that I didn't check it before....gee...I just can't win here.
> Rosa
> but your all right about my dogs....as you can see in their pic, they are a wonderful family to me!!!


I read that the medication you are on can increase  blood sugar levels as a side effect,and I would report that to your dr.


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## Retired (Jan 16, 2008)

From the Abilify Web Site:

Serious side effects can occur with any antipsychotic medicine, including ABILIFY.  *Tell your healthcare professional right away if you have any conditions or side effects, including the following*:


Very high fever, rigid muscles, shaking, confusion, sweating, or increased heart rate and blood pressure. These may be signs of a condition called neuroleptic malignant syndrome (NMS), a rare but serious side effect which could be fatal
 
Abnormal or uncontrollable movements. These may be signs of a serious condition called tardive dyskinesia (TD), which may be permanent 

Elderly: An increased risk of stroke and ministroke has been reported in a clinical study of elderly patients with dementia-related psychosis 

*Diabetes, risk factors for diabetes (for example, obesity, family history of diabetes), or unexpected increases in thirst, urination, or hunger. Increases in blood sugar levels (hyperglycemia), in some cases serious and associated with coma or death, have been reported in patients taking medicines like ABILIFY. Ask your healthcare professional about the need to monitor your blood sugar level before and during treatment*

The increase in blood sugar with Abilify should be reported to your doctor immediately.  Your doctor would expect to hear about such a side effect because of its seriousness, Rosa.


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