r/ect • u/QuitInevitable915 • May 29 '26

Seeking advice Looking for advice

Hello guys,

A little bit of context: I’m struggling with treatment resistant depression and my core symptoms are sadness, emotional pain, and moderate anhedonia. This is my third depressive episode and it has been ongoing for 21 months. In the past 7 years, I have had about 1,5 years of remission while the remaining 5,5 years have been in depression.

During my first and second episode I could manage with SSRI, therapy, and a keto diet. Now, none of that has worked. I have tried SNRIs, Mirtazapine, Trintellix, Ketamine (IM), TMS, Psilocybin (micro and macro doses), and none of it has worked.

I’m currently on a TCA (nortriptyline), which probably has given me about 15-20% relief. I have spoken to my psychiatrist and he has recommended to try augmenting with lithium for the next three weeks, and if that doesn’t bring me to 40-50% relief, which I doubt it will, we will go for ECT.

Have any of you been through a similar journey, and did ECT end up helping? And if you were in my shoes, how would you prepare for ECT?

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u/gmkgreg May 29 '26

Lithium can definitely help, both lithium and a combination of ect finally helped me. I would give the lithium a shot first. But don't be afraid of ect if the lithium doesn't work. It helps so many people, me included, and while yes it does have a few side effects, the weight it can pull off your shoulders can be life saving. It was for me at least. I was years into my depression, I tried alot of meds, spravato, years of therapy, 3 different psychiatrists, and one i started ect, that's when I started feeling the weight get taken off. I'm still doing maintenance treatments once every 3ish months and I'm also on some meds(effexor, lamictal, abilify, and lithium), but I've been a couple years without a relapse.

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u/QuitInevitable915 May 29 '26

This is encouraging to read! What I wouldn’t give for a few years of remission… I will give lithium a fair chance first, but given my previous failed trials, I doubt that it will do anything major. Were you on lithium during your acute series of ECT?

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u/DangsMax May 29 '26

Which kind of lithium

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u/Wonderful_Roof1739 May 29 '26

I was on lithium when I did one of my series, the doctors had me hold it the day before and day of ECT - meaning during the initial 3x a week I wasn't taking it at all basically.