What can be done for treatment resistant depression?

[@guitarexpert2245]

I did TMS 3 years ago and it made my depression extremley worse. It caused insomnia, pain in my body, weakness , and it's never gone away. Some it works, others does nothing and others make it worse. It bothers me when doctors promote this treatment and say it can't hurt you. Yes it can. It hurt me and it's never gone away. This is just an F.Y I.

[@rebeccaelliott232]

I wish you were my doctor. I have TRD and have been told, after ECT didn't work, that I have run out of options - I imagine you would find something for me.

[@tomjenike6836]

Thank you for this video, very interesting.

[@FalcoStarlight]

Thank you for this interesting information!

[@psychiatristrobertd.mcmull8191]

Thank you for you kind response. Be well.

[@gregorymalchuk272]

@@psychiatristrobertd.mcmull8191 At 23:44 you mention an augmentation strategy using dopamine agonists like pramipexole and requip. Would you consider making a video devoted to those ideas? It would be very interesting. Thank you for these amazing videos!

[@clausmehl8731]

@@psychiatristrobertd.mcmull8191 dear sir do you know a solution for emotional numbness

[@clausmehl8731]

The damage of treatment worsen your depression. Nice to hear.

[@hparamesh]

You said in your videos to take low dose Lithium. Will it mess up my thyroid or cause weight gain at the low dose. I discontinued lithium because it messed up my thyroid & weight gain of over 20 pounds. Should I try Lithium Orotate? Is it safe will it also cause weight gain & thyroid issues.

[@debrajanzen6661]

Thanks for making this video. Going to try NAC which will hopefully work.

[@vivienwilliams1538]

I don't know if these kinds of treatment are available on the NHS in the UK, or if they are trusted. I will talk to my GP,

[@p5aul789]

I have been depressed since early childhood. I believe the cause of my depression to be emotional neglect. Both my parents were dysfunctional. My Mother, critical and unloving. Am I ever going to be rid of this burden?

[@andrewcox4068]

Sorry Malcolm. I have depression too it’s hard to. Get out of bed. I’m not a dr but you should talk to your dr about a medication and a Counseling. Take care man your in my prayers. God bless you. I feel for you

[@dystoniaify]

I have been depressed my entire life and then six years ago, I had a rare bilateral putamen infarction at age 30. I now am suicidal and have dystonia and Parkinsonism. I was also just diagnosed with post lasik ectasia from lasik in 2005. I have been on clonezapam 3mg daily for dystonia spasms. I will be on it for life. Unfortunately, none of nontraditional treatments such as TMS. I am on Adderall for depression which after a year isn't helping as much. Lexapro was the only ssri that helped but it makes my damaged eyes too dry. I've lost hope. Do you have any colleagues in Portland Oregon who accept Medicare and medicaid?

[@psychiatristrobertd.mcmull8191]

I am not sure I know of a good psychiatrist there. One thing you might do is call the local chapter of NAMI - FAMI -National Alliance for the Mentally Ill , Friends and Family of the mentally ill. All the best to you.

[@mickhal1681]

dystoniaify Take tramadol If it’s a dead end Then opioids work

[@sultanalgaber3113]

Dont lose hope keep trying i reccomend talk with your doctor about electro convulsive therapy it may be good choice for your depression or mao inhibitors

[@gregorymalchuk272]

Bethanechol is a medication that counteracts the anti-cholinergic effects of antidepressants like dry mouth, constipation, and the lesser known problem of dry eyes.

[@sultanalgaber3113]

Hi

[@jpmcfluffies9451]

I was stable for years. Then October 2019 everything went downhill. I have been on a variety of medications over the last decade. I am currently on Wellbutrin, Lamictal, Gabapentin and Seroquel. I am at the end of my rope. I found out this week, that my insurance will not cover the TMS. I am devastated. If I lived in the US, I would have no issues with having TMS covered, but because I live in Bermuda, my insurance is next to nothing for mental health. It is AWFUL. I got a quote from Brigham and Womens Hospital and each TMS treatment is $1660.00 x 30 sessions. Its just not possible, I can't afford this. My final medication trial is Tricyclics and finally a MAO Inhibitor if the tricyclic doesn't work. That's all I can do. I am unable to work anymore. Can barely leave this house. I can't do this much longer.

[@jpmcfluffies9451]

@@RaviShankar-ek5lr Thank you so much

[@TzadikTheManic]

@Jessica P Mello I understand, I feel exactly the same as you; for me the pandemic made my daily hell that much worse; I was frequently suicidal prior to covid & now I feel suicidal 80% of the time. I have TRD as well as debilitating anxiety/agitation/ocd/intrusive thoughts & I’m barely getting out of bed, almost never leaving my apt or seeing the sun. I’m in the US and I tried to get TMS but my insurance didn’t cover it - I was quoted $7000.00 as a “discount” so of course I couldn’t do it. I wish I had happy, hopeful words for you; but I know what your going through thus I can only say “hang on” the best you can, please... I’m trying but also don’t know how much longer I can do this. ~If you care to talk via KZbin I’m here....I avoid all my friends, that’s nothing new, but talking to a fellow spirit who is suffering, that’s something I feel I can & should do. ~Regards

[@TzadikTheManic]

@Jessica P Mello -Also wanted to wish you good luck w trying a tricyclic 🤞 The trial/error is so frustrating, tedious, and well...depressing. I tried one 10 years ago (Nortriptyline) during a similarly dark time and it literally made me psychotic, something I don’t otherwise experience. I hope it agrees with you, whichever you take. ~Cheers

[@TzadikTheManic]

@@RaviShankar-ek5lr Hi there, nice of you to reply. Sorry to hear you too struggle this way; are you saying you stopped working because of your depression or was it due to the pandemic, & then also depression? I’m not familiar with the medicine you mentioned - I’m guessing it’s not available where I am, or has a different name.

[@TzadikTheManic]

@@RaviShankar-ek5lr Yes, hanging on is all there is it seems. Of course these videos are very informative, so I’m hoping I can try something “new” even if it’s not a med. sorry you have no support - my parents have always been very supportive but since the pandemic I can’t really visit them :( So I’m always alone, stuck in my head. Oh, that’s a great name you have, RS was great ;) -Cheers

[@Dad_Brad]

My doctor prescribed me 150mg lithium carbonate to augment my SSRI. Should it be changed to lithium orotate?

[@hparamesh]

I have heard that orotate form doesn’t cause any side effects. It is all natural Lithium. I was on Lithium carbonate & it screwed up my thyroid & gained about 20 pounds. I discontinued it. I’m now On Latuda an atypical antipsychotic no problem. Never take Lithium carbonate

[@ShayVidz]

Hello, I called in to your office and asked to speak to you, are you available for a consultation? I live in Michigan and would like to get a new analysis on my clinical depression. Please write me back. Thank you. Shayna.

[@arthurmario5996]

you should call the phone number; this guy seems like he might be good. best of luck!

[@IsThereBacon1]

You said that it's best to go on vegan diet, then said eating fish oils are great straight after it? I wouldn't say that vegan diet the answer. A properly balanced diet is the best regardless.

[@stevensicherman4101]

Can TMS take care of treatment resistant melancholic depression?

[@NothingElseMatterz]

Hello, What Brand of NAC do you recommend? Thanks.

[@lonny2764]

I’ve had great results with 600mg of Nac and 500mg of tryptophan at bedtime. I make sure not to have any food for 90 minutes so it doesn’t compete with the supplements.

[@stevemarx6204]

Lonny C what is NAC ?

[@richardjesteadt3474]

Thx so much.

[@feritdchannel848]

can you put subtitles ?

[@coupdefoudre5352]

You know you can do that yourself on here right? At top right hand side of video it gives you options to having captions on or off.

[@clausmehl8731]

Trd the effect of ssri treatment

[@marlene1546]

Dr. McMillan I just want to say I watch all your videos I have such high respect for you I live in Atlanta Georgia I wish I lived in New York where I could see you for the last 3 years I have been treatment-resistant I have used multiple antidepressants as well as added on Abilify 2mg Lamictal 100 mg but not all at the same time so I have tried lots of different things I would love to do TMS at this point I'm willing to try anything do you ever speak with patients out of state and do you have any advice for me this all started 3 years ago when I had my last baby I was 38 years old he was a big surprise but also a blessing I have been married for 25 years to my high school sweetheart I have also two grown children after I have my last baby 3 years ago Isaac I got severe postpartum and no medication has seeming to work since then I did not have lifelong depression I have had anxiety off and on most of my life I think the biggest thing that scares me is the Suicidal Thoughts so I would love it if you could give me some advice thank you so much

[@alexandraalbertz8236]

Marlene fortner keep the faith. Something has to work. I struggle too

[@garysimone4977]

Alexandra Albertz google NDA

[@tomjerry5916]

Selegiung Maoi ?

[@fasthackm]

I take 900 mgs Lithium for Bipolar type 1. Problem is it is notorious for stealing calcium from your bone, in my case my spine. I also have a serious spinal disease which is exhausterbated by Lithium and it is noticeable. What can I do?, I've tried the rest of the other garbage

[@kellykirkpatrick8978]

Have you looked into vitamin D deficiency? That could be part of the problem they say most of us are very deficient in vitamin D and it's causing a real significant decline in our health look into Vitamin D

[@gregorymalchuk272]

He is recommending lithium oroate, not the much more common lithium carbonate. I don't know if that makes a difference on the bone density issues.

[@bazeedkhan897]

I am taking antidepressants and antipsychotics from two years still weird and bad situation not getting eradication from depression and anxiety sir mcmullen what should i do now ..?

[@Matthew_Scan]

nothing can be done in my case tried everything

[@psychiatristrobertd.mcmull8191]

Keep looking for solutions, you never know! Be well!

[@garysimone4977]

@Dragovic Aleksa get your testosterone ck look at the symptoms of low T

[@garysimone4977]

@@psychiatristrobertd.mcmull8191 ya nevet know Yup that sums up psych One big never know. give xyz s shot Ya never know

[@hparamesh]

Me too tried everything in the sky.

[@tomjerry5916]

I’m the sane way Tms neruttopic cardio meds life style Eskatamin Nerufeedback journal trying mind fullness is hard sleep hormones and still depressed and mentally exusted Tms bring it remission but didn’t last long for me I’m may try deep brain stimulation

[@LucyFre]

Im not depressed just my personal life failed and im looser in spite of my hard work and trying hard in life to do things.Its situation when you rich certain age and realised your personal and professional life went wrong and nobody and nothing is waiting for you in your life. Like you are dead men walking 🤣.Im not feeling depressed because of it ... Just dont feel anything anymore . Kind'a emptyness numbness..

[@izkykhan9310]

Depression is not curable its suicideable it ruins your life sucks 😭😭

[@clausmehl8731]

Only after antidepressants its not treatable

[@Yasen1791]

TMS did nothing

[@garysimone4977]

Plant based diet