Any Alternative Treatments Not Widely Discussed?

Hi,

Recently, I’ve been struggling with uncontrollable anxiety and depression- something that I’ve been struggling for years. I got no relief from a handful of SSRIs, Nothing from TMS, limited relief from meditation, or any completely natural methods. I’ve done Ketamine last year - an initial 6 infusions and a few boosters- They gave me very temporary relief (The day after each infusion I usually felt good, but it quickly wore off and due to the price it wasn’t worth it). I’ve taken ketamine lozenges- usually 100MG-125MG and it helps me for a few hours, but nothing substantive. I’m also aware of Mushrooms- but isn’t an option at this time.

My question is - are there any other realistic alternative treatments that are not as widely discussed? I’m desperate and my situation has become much worse bc of the lockdown.

Also, my doctor says if ketamine helps, then that means it’s generally effective- despite the timing. I’ve read a lot about an afterglow, so I don’t really buy it.

Any help is appreciated.

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I would look into Nardil. Have heard many good things about it as both an anxiolytic and antidepressant. Worth mentioning that it comes with nasty side effects like sexual dysfunction and weight gain.

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Hello! Welcome to the community! We’re glad you’re reaching out. :slight_smile:

Also I’m no mental health/medical expert so take anything I say with a grain of salt! But just out of curiosity, have you’ve tried any SNRIs, like Cymbalta or Pristiq? I know Cymbalta has done wonders for my anxiety (that being said, I had increase of anxiety in the beginning taking the medication, but it passed once I adjusted to it), and I have an intuition it was more the norepinephrine effect that had the greatest impact on me.

Also, sometimes treatment can take in the form of a variety of things, the form of which we’d sometimes least expect it! I guess one example is this documentary I watched where this guy was talking about how he was anxious and depressed, until suddenly he realized that drinking blood was the solution for him! (I’m in no way suggesting you become a vampire lol). The point is that it’s great you’re still at it, still exploring what makes you feel okay good. And whatever works for you is honestly whatever works for you, which can open up a lot more options. Possibly the answer for you is super personalized, and involves dressing up in onesie howling at the moon every night (ok maybe that’s my answer lol).

ANYWAY one question you can ask yourself is–what opportunities/experiences/etc have you’ve been denying yourself because they seem frivolous? Just make sure to stay safe and uh, not bite people without their consent. :slight_smile:

Another thing that can be overlooked when dealing things anxiety/depression is looking at things from a trauma perspective. You needn’t have grown up in a war zone to benefit from taking a look at PTSD treatment! One book that was super helpful to me when I was at my worst was “The Body Keeps the Score” by Bessel van der Kolk, which basically argues that the resolution of trauma can’t just be talked through, or even medicated through, but there also has to be a bodily component. In that sphere, somatic experiencing (basically focusing on bodily sensations with some extra stuff) worked for me (like it really helped when I had some memory problems and somatic hallucinations), but something else might resonate for you!

That being said, there’s also other flavors of brain stimulation, like electroconvulsive therapy and deep brain stimulation. My knowledge is limited, but I know they can be super helpful in severe cases! There’s also neurofeedback, though I don’t think it’s as well established as ECT and deep brain stimulation (and I think insurance doesn’t doesn’t cover it.)

Also you might want to get your thyroid checked! It’s something I’ve heard a few time. I knew someone who had depression until she got thyroid medication and that basically resolved it for her.

I’ll also ask around and see what other, more experienced people have to say!

But hopefully this gives you some more options to explore! Or just kill time until something even better comes around. Usually there isn’t a quick fix, but layers of things. Every gain is victory, and every loss is a chance to learn something!

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Hi Rob,
haha I would agree with @giovani that becoming a vampire probably won’t help…
I am not a medical professional either but based on this article, there is ECT, deep brain stimulation, vagus nerve stimulation. It might be worth asking your doctor about these. If not, maybe your psychiatrist can suggest some SSRI + augmentation agents + psychotherapy + meditation combinations?

I wish I could be more helpful - I will let you know if I hear anything. Best wishes, you are in my thoughts

Thanks for the detailed response! I’ve tried a wide variety of traditional antidepressants - including cymbalta- they’ve always made me worse and I’m at a point where I’m not really risking to try a long term treatment which I’ve basically done already and has done horrible things to my mental illness in the past.

I definitely agree with the PTSD approach. During my ketamine experience, definitely tried to find trauma to resolve, but it’s just hard to pinpoint when nothing obvious is there.

ECT terrifies me. I have tried neurofeedback, didn’t do much. DBS is interesting, but I always thought it was similar to TMS.

Ive had extensive bloodwork multiple times before - besides some intolerances to dairy, etc… nothing really significant. And I have cut them out and have seen no changes.

Got it! It’s good that you’ve tried a lot, but it’s also good that you haven’t tried everything.

Looking into resources on complex PTSD might further the plot, which is basically trauma without an obvious cause! There’s a few workbooks on Amazon that might also be a good starting point (though definitely rec The Body Keeps the Score still as another starting point!).

There’s also the book “Self-Compassion” by Kristen Neff! It’s uh, basically about self-compassion lol. It won’t solve all your life’s problems, but it’s definitely super helpful in terms of reframing pain so that it’s just a tiny bit more manageable.

I feel like you’ve also gone through the traditional talk therapy route and might have heard this before (if so, just skiiip), but just throwing it out there: David Burns, “Feeling Good” is still a good self-help book.

Yeah ECT sounds terrifying! :sweat_smile:. Like jwrld mentioned, there’s also vagus nerve stimulation, which might uh, spice things up a little without seeming too terrifying because the focus isn’t directly on your brain. But if you’re worried about the memory side effects of ECT, you can talk to me about memory stuff for support! There’s a few things that you can do that makes the potential memory loss from ECT a little more manageable if that’s your only recourse.

Oh and there’s also other kinds of meditation that might be helpful, in case you haven’t heard of them! Compassion meditation and death meditation for instance. I can’t say again they’re a one-and-done thing, but again might make life just a tiny bit more bearable.

Anyway, just to reiterate, super awesome that you’re reaching out!

I have a lot more to say on this topic, but I’ve already been procrastinating too much here lol. I just wanted to make sure to put in another vote for MAOIs — though they are not “alternative” per se, they are grossly underutilized despite a very long and excellent clinical track record. Other than that, if you’ve been burnt out on the SSRI/SNRI/AAP carousel already, I think lithium has a sufficiently distinct mechanism of action that makes it worth considering, especially as an adjunct.

Thyroid meds too, even in some cases where you’re not technically hypothyroid. Galantamine, supplement, also as an adjunct. Pramipexole: next to MAOIs, I’d say this the most effective-yet-underused med, especially if anhedonia is one of your most prominent symptoms. DBS: not super realistic rn, but very promising preliminary results and something to keep an eye on. From the more conventional menu, I’d say mirtazapine, mianserin (unfortunately not available in the US anymore), and amitriptyline. And the one antipsychotic which inexplicably appears very effective even in the TRD cases is olanzapine, especially when combined with prozac or zoloft. However, it also carries a heavy side-effect burden unfortunately which makes it less tolerable long-term. Other than that, you’ve got your other psychedelics and MDMA along with opioid partial agonists like bupernorphine and tianeptine (which many swear by).

So the answer is yes, though none of these options are really ideal, and I really hope that through breakthroughs in fundamental research and precision medicine we can do better than haphazardly subjecting ourselves to a series of guinea pig experiments many of which only lead to partial or no response. I think anyone trying to spin this as a good thing that “we have so many options” is kind of full of shit, but I’d say there’s just enough that you shouldn’t despair.

Ive done 2 separate rounds of ECT…6 sessions each time. I dont recommend it. I saw very little relief and it ruined some of my memories. Just erased them… Ive also done TMS, Neurofeedback, Meditation, tons of counseling and about 12 different antidepressants. Nothing has ever really worked for me.