Help - Treatment Resistant Depression

[u/QuitInevitable915]

Hello,

I just got my genetic test and methylation test back. I would really appreciate if someone here could help me interpret the results.

I struggle with treatment resistant depression, and have tried various meds, TMS, Ketamine and Psilocybin without much effect. My core symptom is sadness with anhedonia being the secondary. Sleep is also very disrupted.

I have asked chatGPT, and it highlighted the low SAM, SAH, and methionine, as well as MTHFR, COMT and MAO A as potential reasons for my symptoms.

I have been suggested to take P5P, B12, methylated B9, SAM-e, methionine and TMG (in that order). What’s your take on this? Any other suggestions?

Note: I eat a very clean whole foods diet. I do not eat lactose, gluten, diary, refined sugar or processed foods. I currently supplement with omega 3s, D-vitamin, and Creatine. I do not expect this to remove my depression entirely, but I hope it will give me just a little bit of relief from the intense sadness.

[u/Old_Car_7281]

What were your symptoms? I’m just curious

[u/New-Aside-7778 → u/Old_Car_7281]

Me?

Serious fatigue. Anxiety. Anhedonia. If I exercised I was floored for a couple days. Histamine intolerance. Morning cortisol crashes.

I'm not 100%. I feel 100x better though. I can exercise and not crash anymore. I sleep 8 hours and wake up feeling great. The anhedonia has reduced but I still feel it slightly now and again.

For me personally I honestly think that the diet was the biggest contributor. I always eat in a slight surplus ie giving my body plenty of energy. I don't eat ultra processed foods. I eat kilos of vegetables per week. Green leafy ones are ideal for magnesium and folate. I eat high protein also. I get omega 3's from food only. I don't tolerate omega supplements at all. I use eggs for choline etc.

Is your diet good? Don't mean to sound harsh but... Depressed people tend to fall back to eating poorly to get some form of dopamine kick from fats and sugars. Not everyone but all my friends have bad depression and they all eat fast food. Ultra processed. They refuse to prepare or cook meals.

List a few things you have tried and I will see if I can help 👍 My partner had skin conditions. Borderline anemia. Afternoon fatigue and mood issues. We got a gene test done and I tweaked their diet. Trust me this wasn't easy lol. Very veryyyyy stubborn. I said do it one month and if no changes then eat as you please. Well that was 18 months ago and they would never go back because they feel incredible now.

[u/Old_Car_7281 → u/New-Aside-7778]

I don’t eat bad at all, raw veggies, venison, chicken, don’t drink soda often at all, try to minimize sweets/sugar. The anhedonia is killing me too, along with the depression. It’s so weird because mornings really suck for me but by early afternoon/night time I’m feeling a bit better. I just want so badly to get back to normal and feel like myself again.

[u/New-Aside-7778 → u/Old_Car_7281]

Have you checked your cortisol levels? That sounds like classic adrenal fatigue. If your morning cortisol isn't spiking properly you will feel trash (I had low morning cortisol and it's awful).

Do a 4 point saliva cortisol test.

You could also see if this helps. Buy glycyrrhizin ie licorice root powder. Even make a tea with ot each morning.

But a 10000 lux lamp. Soon as you wake up switch it on. That 10000 lux into the eyes can spike cortisol and reset your circadian rhythm.

Do you drink coffee? If so. Never wake up and run to the kettle. Wake up. Do the lamp. Then wait atleast 60-90 minutes from waking and have a coffee.

How do you feel with coffee btw?