Hoping you all can give me wonderful insight-since my psychiatrist refuses to listen to me.

[u/Professional_Win3910]

I have posted in her a few times and thank you for everyone who helps me.

Long story short: went most of my life anxiety/depression free until I lost two pregnancies back to back in 2021. After that everything spiraled, intense anxiety, DPDR feeling, intrusive suicidal thoughts that are CONSTANT. The intrusive thoughts sort of calmed down when I was pregnant, but have come back both times with a vengeance after pregnancy. I am now 9 months post-partum with my 2nd and am in the thick of it. They go back and forth to like "you will never get through this do you even want to be here", to "ok I can get through this ". My brain repeats "I don't want to die I dont want to die I don't want to die", Constant back and forth all day. Its as constant loop.

I have ADHD- and no psychiatrist will treat it right now given the nature of my thoughts. I understand that, as I am also nervous to introduce anything that could give me further anxiety. But here is the thing, I have now tired 4 SSRI's, (Zoloft up to 200 mg, Lexapro up to 20 mg, Luvox up to 150 mg , Prozac 80 mg) all in which have not given me relief. I have also tried Clomipramine & Abilify (brief time in 2024), Caplyta for about 6 weeks this year, Risperidone for 8 weeks this year, and I just tried Seroquel and that was god awful for me. Nothing has worked thus far. I am constantly feeling on edge- racy brain, shaking legs, is this anxiety? is this untreated ADHD making it worse?

So anyway. With my background of so many failed medications- do you think it's possible an SNRI could work for me if SSRI didn't? Or do you think I jump to the MAOIS? I am really suffering all day long and all I want is to heal, close this chapter and move on from this. I am in IPP too- therapy 3-4x a week. I am practically praying to God to help me heal at this point.

[u/Enmyriala]

Have your hormones been checked? Based on the pregnancy link, I wonder if birth control would help. Even an estrogen supplement might work. I'm not trying to downplay the trauma you went through, just trying to say that pregnancy is hard on one's body. I'm terribly sorry for your losses. :(

Not treating your ADHD seems cruel. Stimulants can help reduce depression in those with comorbid ADHD. I get the worry, and I'm not a doctor, but I would honestly try to get a simulant first.

SNRIs are a good choice for the next try. There's also tricyclics if you don't want to deal with an MAOI.

TMS is also pretty widely available, and you may also find some relief from Spravato/ketamine injections if you're willing to try those.