I feel ashamed and I’m a mental health provider (LCSW in a hospital). This isn’t the 20mg Lexapro type of depression that’s pretty socially acceptable these days (everyone’s on SOMETHING, amirite?). It’s tx resistant, refractory, and so chronic. Im on 3 different psych meds (Wellbutrin 450, Vibryd 40, Abilify 50) and now starting rTMS round two. This is what I refer to as “crazytown” type of depression. 

Intellectually I understand this is all wrong-headed. I’m an advocate against mental illness stigma ffs! But I feel like a fucking failure and can’t shake it. Will I need more TMS in 2024? Hell, why not just go straight to ECT?

Thanks for listening y’all…