I have been suffering from mental illness from a very young age, at least 6 yo. Only had my depression and anxiety professionally confirmed at the age of 15, went through the gamut of antidepressants "acceptable" for minors, ended up abusing the xanax I was given; started abusing painkillers because of how disinhibited xanax had me (not to mention self-medicating for various physically painful issues doctors would essentially shrug at), stole drugs etc. etc. stayed for a week in mental hospital when this drug abuse led to an overdose/ my only suicide attempt.

Fast forward a bit, medical marijuana essentially saved me from a downward spiral of painkiller abuse/possible death. It was also very helpful in reducing cravings for benzodiazepines. (IMPORTANT NOTE: marijuana is not right for everyone, I live in a medical state that recently legalized and had the support of my mental health practitioners in using it!) Had some slip ups with the pills but nothing I wasn't able to recover from. Currently my physical health is okay enough to manage without cannabis, but I still struggle with pain and the road to recovery will be long; possibly my whole life. This is something I have more or less come to terms with.

Now an adult, ostensibly, still trying to build a life and it's a slow process but I'd be lying if I said I hadn't improved immensely from my teen years. However, I still have suicidal ideation almost daily. I have some hope with my current mix of medication (sertraline/bupropion/low dose lithium) Bupropion seems to help somewhat help with motivation, and somewhat mediates the notorious SSRI/SNRI sexual dysfunction. I thought perhaps the lithium would make the sertraline unnecessary, although I quickly learned that stepping down in dose was a huge mistake when invasive thoughts came back and hit me like a palette of bricks. I don't regret learning this though, if only psychiatry didn't involve so much trial and error! (Hang in there anyone who feels like they've tried everything, and make sure you talk to your doctors/therapists about how things effect you, and make sure they LISTEN!) The nature and frequency of these invasive thoughts (and a few tics) has me suspecting I fall somewhere on the OCD spectrum, but I'm trying very hard not to feed any hypochondriac tendencies and this is another conversation I need to have with my healthcare professionals.

I have tried almost every type of psychiatric drug, supplement, and various types of therapy. The ones I took the longest were, unfortunately, usually the ones that that gave me the most problems. For example, venlafaxine had me convinced it was helping but was putting me into depersonalized/near dissociative states which my psychiatrist didn't believe me about, and the excessive sweating did WAAAY more to increase my anxiety than the drug did to help it. I still don't know what to think about lamotrigine, people who swear by it often seem to doubt it does anything at all. Buspirone never offered me any kind of consistent benefit, did not seem to have any correlation with dose/effect; beyond the terrifying chest pains from an accidental overdose. I have been offered anti-psychotic mood stabilizers multiple times, but I have a couple problems with these; chiefly the high frequency and nature of the side effects. Weight gain is kind of not acceptable; new or worsening heart problems, muscle/movement disorders, and the possibility of them causing hallucinations are all absolutely unacceptable for me. I have known too many people who had terrible experiences with these drugs. The only people I have ever heard of benefitting from these long-term are people with legitimate psychoses/schizophrenia. Of course, I have taken plenty of drugs that had some kind of risk (deadly rashes, anyone?)

I feel that psychiatrists might have been leaning toward bipolar 2 for me, but I really doubt it. The only times I've experienced something approaching hypomania were definitely because of drugs, prescribed or otherwise.

I feel that the lithium has slightly reduced the suicidal ideation. Could easily be a placebo, but why look a gift-placebo in the mouth if it's doing good, right? I am reluctant to take bi-polar doses but in the future, who knows.

There are plenty of other things I've taken but this is kind of rambling, so to the point: Everyday is still very much a battle, the danger of the modestly helping meds suddenly not working seems to loom on the horizon, and I don't want the suicidal ideation to wear me down.

Is electroconvulsive therapy worth it? Is the memory loss an acceptable risk? Can it be attenuated, beyond just using the one hemisphere at time method? It has a very troublesome past but after all I've been through I feel the need to consider everything. Sorry if TL;DR but this is a big choice to make.