A.

A: You pose an interesting situation because you report that you have already tried most of the suggestions I would make in this case. I would definitely suggest looking into possible medical causes. You stated that you have had MRI’s and have been hospitalized so I can only assume you’ve also had blood work done. Adding counseling, a healthy diet and exercise to your treatment plan also usually helps, but again, you state you’ve tried all this. However, have you tried these techniques consistently for a long enough period (at least 6 months) to note improvements?

Have you sought out medical and psychological providers who specialize in treatment resistant depression? If not, I would suggest that you do, because those providers may have strategies that other providers haven’t tried.

In my practice, I have specialized training in trauma as well as holistic/alternative therapeutic techniques. I’ve had great success in getting results with some clients who have not improved in prior treatment. I attribute this to what I call the “shotgun approach.” I’ll throw all my “tricks” at these folks and hope that some of them work. I’ve combined traditional talk therapy with EMDR, guided imagery, hypnosis, mindfulness, relaxation, and EFT. I also typically refer out to massage therapists, energy workers (such as Reiki) and/or acupuncturists, in addition to traditional medical providers.

Given your long standing history of depression, depersonalization and derealization, I wonder if you have any trauma in your history. Keep I mind that some trauma and neglect can occur at such a young age that you may not have memory of it and you might need to ask family members if you experienced anything particularly difficult or traumatic. Also, keep in mind that what one person finds traumatic, another may not.

Bottom line: don’t give up. You are worth it and some day you will find the right combination of techniques and medications to reach consistent improvement. In the meantime, try your best to focus on the good moments.

All the best,

Dr. Holly Counts