New Medicine and Treatment Resistant Depression

So, I saw the new psychiatrist on Friday.  First a nurse called me back to do weight/blood pressure and other stuff.  Then she did a suicide risk assessment again.  Well, I learned my lesson the last time.  I was honest, but I wasn't as honest as I was the first time; there was no way in the world I was dealing with all that again.

So after that, I met with Dr. K.  She was nice enough I guess, but she wasn't very personable.  Anyways, here's the deal.  The medicine I'm currently on (Effexor) is apparently really hard to come off of because there are a lot of withdrawal symptoms; so even if I do some off of it, it'll take awhile because I'm at a higher dosage and you have to come off of it slowly.  We also talked about some of the other medicines I've tried before, and she said based on those, she's not sure what she would prescribe because I've tried anti-depressants from different categories.  (I made sure to mention that at least a couple of those medicines were taken when I was younger (teenage years) so I'm not sure if my body would respond the same way to them now.  I know anti-depressants have different effects in teenagers than they do in adults, so I figured she would want to know in case she wanted to retry one of them.)  So she decided to add a prescription for now: Vyvanse.  So Vyvanse is supposed to treat ADHD, but it is also supposed to help treat BED (Binge Eating Disorder).  It's supposed to help decrease the number of binge days.  I've also been having a really hard time focusing lately (and getting very little school work done), so it should help with that too.  It's a stimulant and thought to work by restoring the balance of certain neurotransmitters in the brain, which means it should help some with the depression as well.  We'll see what happens.  We'll also see about insurance.  When I got the prescription filled, the pharmacy said my insurance required prior authorization for this medicine, so they were gonna fax the doctor.  But I also had a card from the information packet my doctor gave me for a free 30 supply and then another card for a 30-day supply for $15 for 12 months.  So I gave them that too.  I was also getting my other medicines filled, so I was waiting about half an hour and when I paid, this particular medicine didn't cost me anything, but they also gave me back the card for the free month supply.  So I'm not really sure if they got the authorization that fast, or if they just used the card.  But I looked at the packet from the pharmacy and it's originally almost $330!!!!  Wow.

Anyways, this visit with Dr.K has me a little concerned.  There's a thing known as TRD- Treatment Resistant Depression.  What is exactly defined as TRD is up for a debate a little bit, but it's basically defined as a case of depression that doesn't respond to anywhere from two to at least four different antidepressants from different classes. (http://www.webmd.com/depression/guide/treatment-resistant-depression-what-is-treatment-resistant-depression#1) Basically, it's not easily treated.  It takes a lot longer to find a good combination of treatments (between medicine, therapy and lifestyle changes) and it's even possible that no combination will fully treat it.  That's what worries me.  I've made a lot of progress in therapy.  There have been a lot of things that are different from a year ago, but those dark, self-harm, and suicidal parts are still so active and present.  These are the parts that have become unbearable for me.  What if there isn't a way to fully get relief from them? :-/

Something else we're going to try to add to my treatment is an emotional support animal (a cat) but because my apartment complex has a very strict no-pet policy (not even the option to pay for a deposit), it's going to be more difficult because I have to get a letter from my therapist (and maybe even my psychiatrist if I want to have more to provide the apartment office with) and possibly have to fight the complex about it.  Also, I'm not sure yet if I'd be able to afford to have a cat (though I think I can make it work), or if all my roommates would be okay it, even if it's in my room most of the time.  There are also some neurostimulation  treatments that have become available and a little bit more common.  Something like that would take a LOT of research and consideration and a lot of talk with my doctors and therapist.

Things are just really frustrating and I'm getting really discouraged.  I hope the added medicine will have some affect.

EDIT:  So I know that legally the apartment will have to let me have an emotional support animal, but I suspect they will still try to fight it initially, especially because most people/places aren't familiar with the laws around an ESA.  Thankfully, my current therapist is pretty familiar with it.  My old therapist didn't really have any information and was hesitant to write a letter because then it goes into writing that I'm "disabled"  (which technically, I am) and she didn't know who all would have access to the letter, even though I signed a release that she could give information.  She did write a letter, but it didn't really have the information in it that I needed it to to be able to take to the office.