this post was submitted on 30 Dec 2023
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I am not sure if I have a Treatment Resistant Depression, but I sure have been on multiple SSRIS for the last 10 years.

I honestly don't feel any of them have "really worked" besides being numb.

I want to stop taking them eventually, wondering if Ketamine would open me in therapy and make it more meaningful/impacting.

I'm a really anxious person, so the thought of trying Ket or psychedelics always gets me nervous, like permanently making my anxiety worse or wake up some schizophrenia (I have no signs, nor I have relatives)

I know that attentiveness and dopamine regulation won't improve with ket, but has anyone else been able to treat the depression and anxiety that comes with ADHD?

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[–] [email protected] 16 points 11 months ago

There are many many other classes of medications for depression. SNRIs, tricyclics, mood stabilizers, bupropion is a completely different mechanism of action, even drugs that were originally developed to be antipsychotics are used off label.

I agree with others who have suggested that you should see an actual psychiatrist. Other prescribers just don't have the same training and experience as a psychiatrist with a medical doctor license. There are lots of medications available.

[–] [email protected] 9 points 11 months ago

I am doing Ketamine therapy for treatment resistant depression and SI. It worked miracles for the SI, that's almost completely gone. For depression it helps a lot, but that's not going to just go away. If nothing else has helped, I would recommend it. Seriously talk with a real psychiatrist first. They do want you to dissociate though, but it's a pretty harmless feeling for me. I wouldn't have anxiety about it, it's not going to completely rewrite your psyche lol.

[–] [email protected] 9 points 11 months ago* (last edited 11 months ago) (1 children)

So talk to a psychiatrist about this. Not an NP or other, a real psychiatrist.

However, I do know ketamine is useful for TRD, and it’s low dose no need to worry about tripping balls. Electroshock therapy is another useful tool for TRD. Finally Auvelity is a new med that is real good for TRD and depression in general. All are really good, and reported positively by patients.

As for making your anxiety worse? Doubtful. Awakening schizophrenia? Not how it develops so no chance of that.

[–] [email protected] 5 points 11 months ago

I would add to look into transcranial magnetic stimulation as well, it has an insane rate of success.

I've recently been referred to a major hospital that offers this, ketamine, and electroshock therapy, I'm still waiting to be scheduled but I have a long documented history of treatment resistant depression and the many medications I've tried. I've had severe depression for over 25 years now, I'm exhausted and finally have hope for relief.

[–] [email protected] 8 points 11 months ago (1 children)

Have you tried ADHD specific non-stinulant medications to see if they help your depression/anxiety? Strattera really helped mine, and so did Guanfacine. Could also try Wellbutrin too, which didn't work for me.

[–] [email protected] 2 points 10 months ago (1 children)

I was on Wellbutrin too, but it didn't help the ADHD enough, despite improvements in mood. I'm currently on straterra because the scheduled stuff made me nervous. I think it's working, but it's subtle so sometimes I'm not sure.

[–] [email protected] 1 points 10 months ago* (last edited 10 months ago)

What dosage are you at? I personally for myself had to be on 80mg for it to be really noticeable, even then I never had the energy to get anything done when I was just on strattera and not a stimulant.

Why does the scheduled stuff make you nervous? Usually with ADHD, stimulants can help prevent addiction issues down the road, among other benefits. Also, some of them like Vyvanse and Concerta were designed to prevent dependencies forming with the prescription itself.

[–] [email protected] 5 points 11 months ago

Contrary to what others have said, my insurance IS covering my K treatment, but it wasn't recommended until I completed some long avoided therapy. You really only have to worry about permanent mood changes if you are manic/bipolar, otherwise no worries.

[–] Kirth 4 points 11 months ago

As someone, who was on SSRIs for 12 years. With doctors assistance I've weened off it and my last pill was 2 weeks ago. Couple that with just accepting who I was and what this condition meant and how it affects every aspect of life. Though the withdrawal was rough and I'm still feeling the brain zaps, but my quality of life and outlook about the future has improved 1000%. Please only take this as anecdotal as I'm not in an medical profession. But now the only thing I take is Vyvanse and I really was only prescribed that 6 months ago. As other have pointed out I was being treated for a symptom and not a root cause, and while I cannot say one way or another weather K will help you , its really something to talk over with a doctor. I will say that managing the Cause and not the symptoms does make everything else a lot easier. I think the only thing SSRIs were doing for me was making it very easy to be 'detached'.

Good luck on your journey I hope you can find the treatment that works for you.

[–] [email protected] 2 points 11 months ago

Best done under medical supervision.

Have a look through these trials and see if there are any you might be eligible for: https://clinicaltrials.gov/search?cond=Depression%2FAnxiety&intr=Ketamine&aggFilters=status:rec%20not

If you find any, ask your doctor if they'd consider participating, or contact the trialists and find out if there are any doctors near you who are involved.

If your doctor gets involved in research, they might be able to cast the net wider and find a suitable trial for you.

[–] [email protected] 1 points 11 months ago* (last edited 11 months ago)

I have no experience with K, but as someone who has tried psychedelics for self-improvement/mental health reasons, I can say it does help in that it gives you a kick in the rear and clarity of mind to work on your issues. The benefits (i.e. increased motivation & executive function) are short-lived though.

For long-term change I would recommend working with a therapist. In my experience us folks with ADHD really need the structured regimen it provides.

[–] [email protected] 0 points 11 months ago (1 children)

You may already know this but it isn't clear from your post. Depression doesn't come with ADHD, it is caused the effects of ADHD. Like, you get depressed because ADHD makes life harder. I would recommend trying to treat your ADHD first and see if that helps. This can help improve self esteem. If that does help your depression you may need a separate treatment.

You definitely need to speak with a psychiatrist though. Some cases require immediate treatment of depression, which is really how I've seen ketamine being used.

[–] [email protected] 5 points 11 months ago* (last edited 11 months ago)

The lack of dopamine from everyday events can feel like depression. There have been times that I was just so bored of everything and I sat around doing nothing all day. Then thinking back on the wasted day, is kind of depressing.