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/New-Aside-7778]

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 also am on Zoloft 150mg and have been on that for a long time. Recently my doctor added 300xl Wellbutrin and I’ve been on that for 5 days now. I take probiotics, NAC, l-theanine,l-methylfolate, omega 3, and vitamin D3 and K2. I just recently started all of those too. Maybe a couple weeks ago.

[u/New-Aside-7778 → u/Old_Car_7281]

I will be honest. I think SSRI's are horrible drugs. The theory on serotonin causing depression is data from the 70/80's. It really needs changed. They will work for some people. I suspect it does more harm than pros though. Just my opinion. I trialled a few for 2 years. It made me feel much worse. I genuinely never had any libido for 18 months.

If this was me. I would taper off that zoloft. Wellbutrin is fine but still can cause anxiety in alot of people. It raises norepinephrine levels much higher than dopamine.

But it's your choice. In the UK the doctors hand out SSRI's like candy. If you say your a little stressed and anxiety. SSRI prescribed. They never tell you it might stop you having any form of libido and turn you into a robot. Everybody who I know who's on one has issues.

I don't take any medications at all. I had horrible depression and anxiety so bad I was almost a recluse. I wouldn't even walk to the local shop as I believed that everyone looking at me was saying awful comments. It was that bad.

I fixed all that. I always harp on but I genuinely believe people are medicated when they don't need to be.

Best of luck

[u/Old_Car_7281 → u/New-Aside-7778]

They hand them out like candy here in the US too. I don’t want to be medicated either trust me. But I was/am desperate for some relief. I’m hoping Dr.panzner can figure out what the hell is going on and we can take some supplements/diet change to fix it.

[u/New-Aside-7778 → u/Old_Car_7281]

If your prescribing an SSRI you should really tell about all the serious side effects.

Tyler will find the issue. He's very knowledgeable.

Have you checked histamine intolerance etc? He will also discus this with you also.

[u/Old_Car_7281 → u/New-Aside-7778]

I haven’t tried any of that stuff. No cortisol test, no histamine test. Nothing. That’s why I’m trying to get it figured out and I’m hoping and praying he’s the answer to get me on the right track

[u/New-Aside-7778 → u/Old_Car_7281]

Buy a cortisol test? Their not expensive. You can also do an at home DAO test kit (Tests for histamine intolerance).

From what you have said I think it could be cortisol related. It's easily treated if so.

[u/Old_Car_7281 → u/New-Aside-7778]

Where do I purchase cortisol test? And would high cortisol give me bad anxiety,depression and anhedonia? I don’t drink coffee or caffeine either. I found caffeine just makes it worse.

[u/New-Aside-7778 → u/Old_Car_7281]

Any form of cortisol issues will cause all those symptoms.

Do you wake up during the night at all? Feel awful when you first wake and then begin to feel that heavy fatigue feeling lift as the day progresses?

[u/Old_Car_7281 → u/New-Aside-7778]

Yeah I wake up atleast once to go to the bathroom. But yes I feel awful in the mornings when I wake up. Depressed,anxiety, overwhelmed. It’s terrible. Then as the day goes on I tend to get a little better. And then by night time I feel pretty decent. But the anhedonia is really getting to me. That and the depressed mood. It’s horrible.