u/OwlEuphoric9795

22F, 5'6 120ish lbs

I've been dealing with this awful life-disrupting cycle where most of the time I feel moderate depression symptoms (manageable with therapy) but every few months I have a few weeks where I feel like none of my effort has been worth it and I have no future, and nothing is ever going to feel worthwhile. I start scoring very high on the PHQ-9 and I seriously consider ending my life (I've gotten to the point where I've logistically convinced myself it was the best decision, but since I didn't go through with it then, I figure there must be no amount of rumination that will get me there, so it's better to just focus on recovery instead of pushing myself deeper into the episode). Still, my last episode made me sabotage a project I was excited about (and probably needed for my grad school applications) so managing these episodes is pretty important at the moment.

I currently see a Psych NP once a month. She's great for recommending meds, but it seems like I've run out of meds to try. I've attached a list at the end, alongside my response. For every med that didn't have an immediate severe side effect, I was on a therapeutic dose for at least 6 weeks.

I've been in therapy for almost 4 years with a good therapist who I trust. He does CBT/IFS officially, but our sessions are usually a combination of philosophy discussion and "Go easier on yourself ( he's half right, but I feel better when I'm occupied)". It's usually helpful for maintenance, but if I'm checking out of life for 3 weeks every 4 months then it's not fixing anything lomg-term.

I've tried TMS, it made my depression substantially worse (immediate rapid SI) so I'm not eager to try it again. I did a few weeks of DBT IOP (escalated to 2 weeks PHP) 3 years ago and I don't think I'll benefit from more classes on those skills.

Meds I've been on:

1. Fluoxetine/Prozac: No response
2. Sertraline/Zoloft: No response
3. Hydroxizine: Helped me sleep for a few weeks. no longer needed
4. Aripiprozole/Abilify: Immediate significant Tardive Diskinsia
5. Lamotrigine/Lamictal: No response
6. Bupropion/Wellbutrin: No response
7. Duloxitine/Cymbalta: No response (and it was hell to get off of)
8. Mirtazapine: Weight gain + no mood response
9. Modafanil: kept me awake, no other effects
10. Lithium: No response
11. Vorioxetine/Trintilex: No response
12. Dextroamphetamine/Adderall: Helped for a while, switched to Vyvanse when it became less effective
13. Lisdexamphetamine/Vyvanse: Currently on 40mg, it is still helping, but not enough to prevent the MDD episodes
14. Nortriptyline: Tachycardia, (worsened) Orthostatic Hypotension, No mood reponse (I've fainted periodically since I was a child, this med made it worse. After stopping this med I started drinking electrolytes and the Ortho Hypotension was adequately resolved)
15. Desvenlafaxine/Pristiq: Rapid onset SI

16: Esclitalopram/Lexapro: Rapid onset SI

Other Hx:

Severe Scoliosis: spinal fusion in 2020 & April 2026 (second fusion due to Adjacent Segment Disease)

Orthostatic Hypotension: childhood-present, treated with electrolytes 2yrs, normal heart ultrasound

ADHD: adequately treated with Vyvanse

I’ve never heard the term outside of Zelda games. I tried looking it up while excluding a few related keywords but this song was the only thing that showed up.

Context: My first surgery was 6 years ago, I was 16, I had 60° and 30° curves. I was fused T5-L4. I developed lumbar degenerative disc disease (adjacent segment syndrome) that didn’t respond to conservative treatments so now I’m fused T5-Sacrum with bilateral pelvis fixation. Surgery was April 24, I left the hospital on April 27.

Vent: Holy fucking shit everything itches. I had an allergic reaction to the adhesive they used for the wound dressing and now my back looks diseased. I called the hospital and sent them a picture and they’re not worried but FUCK this itches.

I am constipated. I am lonely. Eating isn’t fun. And everything still hurts. Hydrocortisone cream is greasy and gross and sticks to my shirt. My whole abdomen is swollen from the surgery and I look awful. I hate log rolling. I hate sitting. I hate that I had to skip a semester of school (and delay my graduation) for this.

They wouldn’t let me keep the hardware they removed in the revision surgery even though I begged them beforehand. They haven’t even sent me my x rays. None of this feels real.

When will this be over???