I'm not writing this for advice as this is my decision (and my family's)...what I do want is to keep everything real. I have been writing about my struggles with depression for several months now and even though this is intense stuff, it is reality...my reality. I have been real in my writing and updating and I don't want that to change just because things are more acute.
Yesterday was incredibly difficult. I first saw my psychiatrist for a double session and then went right to meet the psychopharmacologist. I was emotionally spent and nervous, but I went. The doctor was very nice and I felt comfortable. He definitely knew what he was talking about and formulated various possibilities after hearing my history and my current state. These are the options:
Most Aggressive: ECT (that's right, shock therapy). Once you get the "Snake Pit" image out of your head, it is very helpful for people where medications are not. It is also not barbaric as it once was (or what you see on TV/movies) and you are under anesthesia for the treatment.
More Aggressive: MAOI medication. It is helpful but I would need to go off all of my current meds and be off of them for 2 weeks. There is also a special diet I would need to follow if I take these meds.
More Aggressive: TMS (Transcranial Magnetic Stimulation) This is relatively new and is very different than ECT. There is no anesthesia, you are awake for the 40 minute treatment, it is not harmful and studies show it is very helpful in people who have not had luck with medications. There is no memory loss as there could be with ECT and no anesthesia to deal with.
Conservative: Another class of medication.
Where I stand (along with my husband and my psychiatrist): stop one medication that is not working and then try the "Conservative" medication and at the same time look into TMS. I am at bottom right now and I feel like we need to do something aggressive. I simply cannot continue to live my life like this. It's not fair to my family and it's not fair to me. The biggest worry will be insurance coverage for the TMS. Mine is not listed as one that accepts it as a treatment for major depression. I will do my due diligence though to find out. Where is the mental health parity? This just adds another level of stress and if I had diabetes, there would be no problem with treatment coverage.