Recently now dubbed three times over, separately, that my bipolar depression and related anxiety is treatment resistant. 

I’m type I, been diagnosed and medicated since I was 12 (12 years now). My mother, father, and grandfather are all also diagnosed with bipolar and coast by unmedicated. All but my father have/had type II — dad type is unknown, he forgot those damn cigarettes at the store in 1998 and I haven’t been able to ask. 

I was diagnosed after my PCP reasonably thought I just had (severe) depression and put me on Lexapro. I like to say it’s the best damn antidepressant I’ve been on but it might just land me in a hospital with psychosis. Since then, I’ve been on countless scripts and combinations of SSRIs, SNRIs, NDRIs, anti-convulsants, antipsychotics, anxiolytics, beta-blockers, and barbiturates. Most with no effect, severe adverse effects, or unmanageable side effects. I have heart conditions so I have to get approval from my cardiologist to try tricyclics (possible option?).

Now, this is the third psychiatrist in two years who has seriously attached the label ‘treatment resistant’ on my bipolar. I just can’t get out of my depression unless I’m intentionally triggering mania or I just get used to it I suppose. Current psych wants to do genetic testing to see if I metabolically “have potential to respond” to specific meds. Company is Invitae but I’m not a sure I believe it can back up its claims tbh…

In the meantime while I research and get approval fr this magic test, psychiatrist wants me to do in office TMS. Now, I did this at 14ish but only a couple times and I cannot remember the outcome/side effects. I’d have to drive an hour total to and from the office on weekdays for around 5 weeks. I have work and I’m in grad school so I’m really concerned as to the scheduling and side effects: *can I drive afterwards*, can I function normally as I am a “remote” social worker during the day and a grad student at night? Besides that: **does it even fucking work???**

Thank you for anyone who can share their experiences with Invitae or TMS!


tldr: treatment-resistant type I, hereditary but no one is medicated but me, diagnosed for half my life, options: genetic testing for medication that would work (?) and TMS. I have a little knowledge on TMS and would like advice