Treatment resistant, on disability, no idea what to do next

[Benderstar]

Hey everyone, I heard about this place just recently. Anyway, to make a long story short, I’m in my late 30s, I have a 20 year history of depression that has flared up badly 10 years ago and just over one year ago. This most recent episode is much worse, and basically ruined my life.

I went on medical leave from work, then applied for disability insurance when it was clear that there was no way in hell I could go back to an incredibly dysfunctional workplace in my state, even with “accommodations”. I already had several of those in place, but it’s hard with a mental illness. How do you pin down exactly the place and duties that make my condition worse?

So, I was quickly approved for disability because of my long medical history, a previous claim, and being under the care of a psychiatrist. I felt a sense of relief at first, because I could then take time to get better and find out what I really wanted to do with my life. Or, so I thought.

Ok. So I proceeded to get counseling through EAP (useless garbage) and privately too. I completed a course of rTMS with absolutely no effect. I tried about 10 more antidepressants, antipsychotics, mood stabilizers. Most were worse than useless. I became so despondent I began self harming and making plans to end my life.

I had to go to the hospital one day, because it was particularly bad. It was terrifying. I got taken to a secure area by security, then sat in a room that looked like a jail cell, and interviewed by a social worker and a psychiatrist. I really didn’t want to stay there, and considering it was the start of the pandemic, they didn’t want to admit a non psychotic patient.

So, more meds, intensive outpatient program, more therapy, until my psychiatrist finally decided to try the MAOI drugs since nothing else worked. I have to admit, Nardil is the only thing that’s come close to doing anything. The side effects are brutal but I can put up with them for the moment.

Ok so finally here’s the big problem: after 2 years, I have to be sick enough that I can’t reasonably do any job that pays a majority of my pre disability income. Right now I have no idea what I can handle and what I’d like to do.

I have very little energy, I get dizzy and nearly faint if I have to go up stairs, I’m frequently confused and forget things, and I’m easily overwhelmed by having more than one task at a time.

Wtf kind of job would work? I should mention that I went to a career counselor last year, took some tests, and they all came back with shit like “medical researcher”, “professor”, “military officer”, “test pilot”. Holy shit. Everything was a job that I’d either have to drop everything for and get my PhD, or something wildly inappropriate given my medical history.

I like sciencey stuff sure, and planes are awesome, but I can’t make a career out of it. I’d need flexible hours, breaks, ability to work from home, not too much stress, and enough money to not be in poverty.

So… do I try occupational rehab and see if I can be accommodated somehow? Or stay on disability until I either die or get better?

[Micro]

Hey @Benderstar,

Welcome here, and thank you so much for sharing about your situation. You’ve been through a lot, you’ve been actively doing what’s needed to take care of yourself, but I understand that, right now, it might be difficult to make a decision regarding your future. Though the decisions and choices are yours to make, but I hope you’ll find some encouragement and food for thoughts here on this forum.

Somehow, your situation really resonate with mine. I’m unemployed right now, originally not because of my mental health, but since I’m not active anymore (+ covid, hell yeah) this year made me realize how bad my anxiety and depression became. Two years ago I was functioning, now even just getting out of bed is exhausting. In a couple of months, I should be officially on disability, but I never thought I’d be in this situation. I’m currently looking after a job and just looking at the requirements make me have anxiety attacks. I have the qualifications and requirements to apply for some pretty decent jobs but just the idea of having responsabilities again is crippling me in ways I rarely experienced. I’m also easily overwhelmed and literally need to keep a notebook with me just to keep track of daily stuff. It’s hard not to feel stuck or frustrated by all of this, and I’ve been struggling with suicidal thoughts as a result.

I’ve been trying to figure out different ways to find a job again, but we all know that we don’t always do what we want when it’s about working. A depression can really feel like this giant wall that seems to interfere with everything again and again. So, for what it’s worth, my heart goes out to you friend. And I want you to know that your efforts are not unseen. You’re really thinking about your possibilities and setting important steps for your future.

Regarding your question, I want to ask you, first and foremost, how do you feel about both these options right now? (occupational rehab/ disability) Also, is it something you discussed with your psychiatrist? (or a therapist) - They can definitely help you to navigate the emotions that you have because of this situation.

You also mentioned not knowing what you can handle or what you’d like to do. A career counselor definitely take in account the second point, but not necessarily the first one. Thinking about this all together could be a good start for you. I’d suggest to try to write down a list of the things that 1/motivates you in a job, and 2/ the things that would be just a big “no” right now. From your prior experiences, what are the things you prefered? What are the things you really don’t want to experience again?

For example, as mentioned before, if I’d have a job tomorrow I’d certainly not be able to handle huge responsabilities (managing a team for example) and I’d preer to be a performer than a decision-maker, while I was doing the opposite before I got unemployed. I’d also certainly prefer to have a half-part time job at first, as a step between days of work/days to rest. It’s okay to take some time to acknowledge where we are now, like taking a photography of both our needs and capacities. If it won’t give you all the answers, it can still give you a direction to look forward. You mentioned flexible hours, work from home, not too much stress, etc. It’s a good start. Looking at job announcements can also really help you to dig deeper and respond to this need of knowing what you can and want to do right now. It helps to make yourself an idea of what’s offered out there and to see how you feel about it.

Finally, in addition to the two choices you mentioned, could volunteering while on disability be an alternative option? Not as a definitive solution of course, but more something to do, for example, for a couple of months in order to train yourself to have a work schedule again, responsibilities, people to meet, things to learn, etc. It could be a first step to measure where you are, how you feel about being partially active again, without the pressure of keeping an income at all cost.

Just a few thoughts and ideas. I’m not sure if this could be of a great help, but for what it’s worth I’m right there with you on the struggle bus. You’re not alone. And I believe that, even if it might take some time, you’ll be able to get out of what probably feels a bit like a rut right now. It’ll just certainly requires plenty of small steps, and not necessarily drastic changes at once. There’s hope, friend. <3

[Benderstar]

Thank you so much. It sounds like I’m not alone in my situation.

Interestingly enough, I went to career counseling last year when I went on medical leave. My interests are in working with my hands and machines, as well as learning about and applying scientific knowledge. Like for example, I don’t want to perform mindless repetitive tasks; I want to learn about the why and use my knowledge to make things better.

Unfortunately my test results came back and recommended careers like medical researcher, civil engineer, military officer, test pilot, and university professor. Sure these sound like pretty awesome jobs, but they require an unrealistic amount of time and schooling or are virtually impossible due to my medical history. I should add that I’m not a single guy in my 20s anymore. I have a home and family responsibilities. I can’t afford to take 6 to 8 years with little income in order to graduate with a PhD or whatever. Not to mention, I can barely concentrate enough to write on here. I can’t imagine going back to school now. I’m kind of astonished I earned a (ultimately useless) degree in my early 20s.

Career counseling made me feel even worse and more confused than ever. I’m going to go over those results again tonight though. Maybe there’s something I missed.

Thanks again for your kindness and letting me know there’s someone in the same situation

[Micro]

Hey @Benderstar,

Late reply here, but thank you so much for your own response! Also, Happy New Year - I hope this one will be a year of growth and peace for you.

Not to mention, I can barely concentrate enough to write on here. I can’t imagine going back to school now. I’m kind of astonished I earned a (ultimately useless) degree in my early 20s.

That definitely makes sense. The pressure of time combined to the need of having an income is real, indeed. I understand how challenging it is to find the right balance between meeting both material and emotional needs at the same time. And through all of this, I really hope that you have some outlets to breathe and get some relief when you need it.

What you describe with your concentration, the fact that you forget things etc. sounds like what some call “brain fog”. I struggle with some symptoms as well, and I agree it feels crippling sometimes. What’s your therapist opinion about this? Do they support you as you need in order to manage those symptoms?

Career counseling made me feel even worse and more confused than ever. I’m going to go over those results again tonight though. Maybe there’s something I missed.

How was it for you to go over those results again?

I hope this week will be a good one to you. Take care. <3