What options are there if meds and therapy haven't worked?

Tried Zoloft, Prozac and Effexor. Have been given a script for Mirtazapine, but I'm not going to bother with it. Tried talking cure, counselling, CBT:  none have helped in the slightest.

And I think they haven't helped because I've slowly realised they can't help: the reality is that my career's a joke, my relationships have failed, and I'm now facing down middle age alone and with my best years firmly behind me. There isn't a way forward that's worth bothering with.

The current situation can't really be changed: I've painted myself into a corner and the sort of life I can have from here doesn't interest me in the slightest. The things I hoped to achieve - family, marriage, professional success - I've missed my chance for, and the life I've created for myself through my failures is inadequateI don't like who I've become, I don't care for what I can do, and any changes I can make to my life will be cosmetic.

Starting again would only be an option if I thought there was something worth doing, which I don't; and if I thought I wouldn't screw it up, which I do. 

The thing I can change about my current situation is that I'm around to be in it, And there's only one solution to that which I can think of.

Hi TC

I am sorry to read that things are hard for you right now.

As far as anti-depressants are concerned, please remember that they can take some time (months) to kick in fully and also matching the “right” med to the “right” person is more an art than a science - it is sometimes called “being on the medi-go-round”.
 
For sure that has been my experience - the first one that I was on was (for me) useless but what I am now on is (for me) great.

A suggestion: give Mirtazapine a try for a few months and see how you go with it.

With care and support.

Thank you, but I am viewing them as mistakes. Specifically, mistakes that can't be fixed leaving me with options that I don't want to have. Learning from them would only be valuable if I thought there were opportunities to try again, and I don't think there is. Having someone pat me on the head and say that everyone makes mistakes changes nothing - and dragging other people down with me would be nothing short of cruel.

Life for you sounds really futile and hopeless at the moment. 

When I was in a similar situation many years ago I felt exhausted, angry, alone and in a world of pain.  All I wanted to do was hideaway because being in this world hurt too much.

Knowing that other people had had similar experiences and reaching out to them for support and understanding made me feel less crazy and less alone and helped me be less critical of myself, my situation and others.  Rather than drag each other down, we gave each other hope and strength.

I then did all I could to get some psychoeducation about depression, relationships, what I did to get what I dont want (eg self sabotaging behaviours) and how to re-build my sense of self.

It was a difficult, uncomfortable and often painful journey and, for me, it was well worth it.  While this journey may not appeal to you, I hope that you do not give up on finding the “way” that is best for you

Good Luck

Thank you. I think I'm beyond all that now though. The thought of going through an exhausting, long and painful process - especially one that would involve potentially hurting other people on the way - in order to be in the exact same situation I'm in sounds like a nightmare.

I perhaps haven't made my position as clear as I might have: I don't want a future that I can achieve. The only future that I'm at all interested in requires things having been entirely different ten years ago, and there's simply no way to catch up at this point. I'm a disgrace to my family legacy, and a disappointment as a man. I have no interest whatsoever in going forward alone and without a family of my own, and I'm no longer capable of having one. So, as far as I'm concerned, that's it. And all the talking or meds or group hand-holding sessions in the world can't change reality.

I'm sorry, I've had these arguments with shrinks before and they just go around and around. I'll leave you to it. But thanks.

Hi TC

This (from Michelle) really resonated with me:

“Knowing that other people had had similar experiences and reaching out to them for support and understanding made me feel less crazy and less alone and helped me be less critical of myself, my situation and others. ”

Once my psychiatrist and I had (through trial-and error) worked out the “right” AD for me, for a couple of years I spent a day a week going to a mood disorders therapy group, run by a qualified clinical psychologist.

I found that very helpful - maybe an option for you to consider?

I really don't see the value in having people tell me I haven't screwed up when I've quite clearly done so. And to be honest, I'm not super fussed about what other people think of me - they're not going to convince me of my secret awesomeness at this stage. I'm not really looking for sympathy or understanding: I want to have not screwed things up in the past and thereby locked myself in my option-free situation, and anything else seems entirely beside the point to me. 

And I realise it's impossible, which leaves me with only one path forward as far as I can see, unless some sort of science fiction solution presents itself. Talking about it just makes me madder and madder, and meds just make me ill. And I honestly can't imagine being in a room with a bunch of other angry failures is going to brighten my mood and make me embrace life.

Sorry, this was kind of a last-ditch thing and I was pretty sure I'd exhausted the options. I'm absolutely not talking about this to anyone in my actual life, because I'm not a monster, it's not their fault I'm a failure and the last thing I want to do is drag people into my self-created hole, so now I just want to put my affairs in order and find a way to disappear relatively cleanly. An unfortunate accident once everything's sorted and I know that won't affect people unduly. People will be sad, but I don't think anyone will be devastated.

Hi TC

This worries me:

"I just want to put my affairs in order and find a way to disappear relatively cleanly. An unfortunate accident "

Sorry if I am wrong but what you have written sounds very close to a suicide note to me.

If you are experiencing suicidal ideation (I have been there, though not recently) *and* have worked out a detailed plan/method then the *only* thing that matters is that you are in a safe place.

That means go, *right now*, to A&E of your closest hospital - there will be people there who can help.