I recently revealed on Instagram that I was finally feeling better after 3 failed anti-depressant runs and a ketamine treatment, a search for over a year to feel better from the depression that has crippled me for 3 years. I was overwhelmed with the responses, so many kind ones and then SO many other ones wondering what medication worked and what I did to get better. I wanted to answer them all, but it is a much more complicated answer than just the new drug I was taking. I also understand the desperation to try anything that will help which is why I am writing a very comprehensive post on my depression treatment plan.
This is my current treatment plan and please note I am under care. My treatment and medication is not going to work for everyone, just as anti-depressants did not work for me. Supplements, although considered “natural”, can still be harmful if they interact with another medication and the amount of dosage can be hurtful. Please consult with a professional to develop a plan that may work for you. I am not a doctor or a mental health professional, just a person who has depression and sharing my experiences. If you are suffering from depression and/or suicidal thoughts, please reach out- National Suicide Prevention Lifeline
My current treatment-
My official diagnosis is mood disorder unspecified, treatment resistant depression & PTSD.
I currently see a trauma therapist and it includes EMDR, workbooks and talk therapy. I do not see a therapist specifically for depression. I am on a break from EMDR until I am stabilized on medication. I often experience a spike in PTSD symptoms after sessions (nightmares, flashbacks) and it can make my depression spiral. I hope I can continue once I am stable.
When I had PPD after my second child, I went to a therapist and we used cognitive behavioral therapy, I still use those techniques today- it is a great asset for me.
I currently take Lamotrigine, which is a mood disorder medication. I am weaning off Wellbutrin, it seems to have increased my anxiety and not been helpful for the depression. However, until I am completely stable, we cannot eliminate it until we know what is working or not. This is why it is very important to have a doctor monitor me, I cannot just stop a medication and go cold turkey. I previously tried 3 anti-depressants that did not work for me (I tried Zoloft, Viibryd and Wellbutrin)
Genesight Testing– this test helps your doctor choose medications. It is a simple swab of your mouth and the results show what medications are more likely and not likely to work for you. For instance, it showed Zoloft would most likely not work and could help avoid some of the guesswork involved in choosing medication.
It shows that my current medication, Lamotrigine, my body metabolizes quickly, which most likely means I need a higher dosage.
I see an Integrative Psychiatric Nurse Practitioner (Denise Drake if you are located in the Phoenix area.)
Integrative means they look at the whole body picture, not just medication, although they can prescribe medication. In my case, I have been to four traditional therapists and she is my 3rd psychiatric and every one of them has agreed I need medication.
I saw two traditional psychiatrists and I did not like either one. I felt stuck and hopeless with them, as if they threw medication on a wall to see what stuck, saw me for 15 minutes and I paid $200plus for someone who would not listen to me.
Deplin (I actually take this after my AM workout)- considered a medical food, it is prescription only, but it is folate. My genesight showed I was low in folate, which increases depression and can make your anti-depressant be less effective as you need normal/high levels of folate. My gynecologist also noted this when I was pregnant and recommended it.
Genuis Joy– I started this on my own after conducting a ton of research. It is a nootropic supplement meant to help with depression. She was very impressed with ingredients and had me continue with it as she made other adjustments.
Etsrogen Blocker- I am estrogen dominant (blood test results) I do not take this for depression, but simply just including all the info.
Cortisol Manager– taken specifically for my PTSD, her theory is that two significant traumas within 6 months of each other, depleted my adrenals and she wants my body to return to the proper homeostasis.
Vitamin D- a simple blood test can show your levels. I am low in Vitamin D which is known to cause depression. Also, this is why I like an integrative practitioner. My level is 33. Insufficient levels of vitamin D is considered anything 30 and below. Sooooo, 33 is not great and optimal levels are between 60-80. I understand the need for doctors to quickly look at results and to require a standard to make decisions. This is why being proactive in your individual care is important.
Magnesium- taken for depression (also great for recovery to muscles from working out!)
These lifestyle activities are obviously important to everyone, not just mental illness sufferers and I know many of these can be hard to do when suffering from depression.
These are the two impactful ones for me:
Sleep- If I get little sleep too many days in a row, it extremely affects my depression. I have learned to protect my sleep and if exhausted will choose a nap over errands. I have trouble taking naps (always have) so going to bed early is more the option I use.
I also have a sleeping pill- it is Hydroxyzine Hcl- I take the lowest dose and I compare it to a stronger Benadryl. I take it if I have had too many days of rough sleep and absolutely need a good nights sleep to recover. My insomnia usually causes me to wake in middle of night and unable to stop thoughts. The medication keeps me asleep. It is hard for me to wake up, but once I am up all the groggy effects leave.
Exercise- If getting out of bed is impossible, workouts can seem insurmountable. A long time ago, I committed to at least 30 minutes on bike when I was in a bad state. Any small commitment- a walk around the block- can be helpful. I now workout 4-5 times a week (weight training & HIIT) and do light activity on my non-workout days. I still use the 30 minute on a bike commitment when I have no energy to workout.
Sleep and exercise are the most beneficial for me, I notice a drastic improvement or spiraling if I am missing out on these.
Nutrition- I think everyone has to find what works for them, but basically if you eat like crap, you will feel like crap.
Gut Health- she switched me to a low acid coffee and it is why I take probiotics at night. On my own, I drink kombucha and incorporate more fermented foods in my diet.
Alcohol- abstinence is best here regarding mental health and it is often used to self medicate. But, I really love wine and the occasional cocktail, I am a total foodie and wine goes hand in hand that for me. I discussed this with my practitioner and she said a low amount is acceptable. I recently attended Alt Summit and was worried about the excessive drinking (cocktail parties, happy hours, etc) and asked her about it because I wanted to participate in it (lol) and she said excessive drinking briefly is not going to derail everything and I would be ok. Please note, I asked her about it- they are not there to judge you, they are there to help you make good decisions. She in absolutely no way promotes alcohol use and it mixes with most medication negatively.
Also, I personally have not noticed alcohol use increasing or decreasing my depression (or maybe I am in denial). If I am in a very bad space, I abstain.
Please read this post with other coping mechanisms I use since this post is already super long, lol.
One of the things that is VERY exhausting for me is if I miss my self care activities, I suffer greatly. It is exhausting keeping on top of it all. I have never been well enough to go on vacation or a work trip and miss sleep, skip a workout, splurge a bit and be ok. My mental health always suffered. I would never give up on a healthy lifestyle but I would love to go on vacation and relax without suffering dire consequences to my mental health.
I have to be proactive in my care, I stayed with too many therapists for far too long because depression destroys motivation and I used any energy I had to take care of my kids. If you are seeing a therapist and actually listening and practicing their advice and you are NOT improving, find someone else. It is so difficult to find someone new especially under the weight of depression but my inability to do so, prolonged any recovery. Maybe a loved one can help, by simply reaching out and saying, I need help, a new therapist, something, anything.
Am I better? No, not yet but I hope I am finally on the right road to recovery. And I hope you find that road too.
I am not a doctor or a mental health professional, just a person who has depression and sharing my experiences. If you are suffering from depression/suicidal thoughts, please reach out- National Suicide Prevention Lifeline
And know that YOU ARE NOT ALONE.