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Here is what I usually post about it:

Please research Ketamine and TMS (transcranial magnetic stimulation). They are some of the most promising newer treatments, because they have worked where so many others failed. TMS is already FDA approved for MDD and ketamine is already used as an anesthetic (amongst other things) and is on its way to approval for MDD.

Some Ketamine studies you can read if you like:

http://www.ncbi.nlm.nih.gov/pubmed/20673547

http://www.ncbi.nlm.nih.gov/pubmed/16894061

http://www.ncbi.nlm.nih.gov/pubmed/21037130

http://www.ncbi.nlm.nih.gov/pubmed/20838494

http://www.ncbi.nlm.nih.gov/pubmed/19897179

http://www.ncbi.nlm.nih.gov/pubmed/21557878

http://www.ncbi.nlm.nih.gov/pubmed/21450159

http://www.ncbi.nlm.nih.gov/pubmed/22303887

http://www.ncbi.nlm.nih.gov/pubmed/21135850

The main reason I focus on Ketamine is because it is truly unique as a treatment. It can work rapidly, as in hours or days, not weeks. It is very safe at the sub-anesthetic sub-recreational dose and has been effective in extremely treatment resistant patients. I remember reading a case study of a 40 year old woman who had tried everything: over a dozen different medications and ECT. They give her Ketamine and for the first time in decades she felt better. Her child said "my mommy is back." Heartbreaking.

Also, a book I recommend: The Depression Cure: The 6-Step Program to Beat Depression without Drugs. It is NOT an anti-drug book, it's a try- these-first-since-they-are-good-for-you-anyway book. You can start doing what this book says while pursuing other treatment.

You can search for clinical trials for depression and Ketamine here. They are even working on intranasal delivery.


To answer your question directly, you can get it legitimately by enrolling in a study. The dose they use in studies is .5mg/kg over 40 minutes (IV). But optimum dose and delivery is still being studied.

I really hope this helps, and I would love to hear your experience if you do it.

Sure, here goes:

1: Honestly, I do not see very many live patients. My role as a pathologist is mostly making diagnoses based on histological samples (i.e. looking at stuff under a microscope), as well as doing autopsies. That being said, from what I hear from colleagues (and sometimes experience for myself), this fear does indeed exist, and it is unfounded. Doctors will occasionally 'infringe' upon a patients rights, but almost always (with very VERY few exceptions by bad doctors) because it is in the best interest of the patient.

An example: in med school I was shadowing a neurologist/infectious disease specialist/psychiatrist (the guy had 3 specialties but in practice he was a neurologist). He got called in for a consult on a patient who wanted to go home about a day after a bone marrow transplant. This is a very bad, because it opens up a patient to a very significant risk of death. Now the patient kind of understood this, but he had had enough of the hospital and wanted to go home. He truly didn't care anymore. That being said, he did not want to die, but he did want to exercise his right to refuse treatment. The doc said 'sure, let me just get you a shot of antibiotics and came back with some 'antibiotics' that promptly made the patient fall asleep.

The point is: doctors will almost always try to act in the best interest of the patient, but not the best interest as the doctor sees it, but as the patient sees it. It might be worthwhile to read the book 'Better' by Atul Gawande, it really makes these kinds of ethical issues very accesible.

http://www.amazon.com/Better-A-Surgeons-Notes-Performance/dp/0312427654

The best way in my opinion to deal with this fear is by acknowledging it and making things as transparent as possible for patients. The difficulty with that is that patients with mental illness will often have trouble understanding that doctors can be trusted, but a psychologist (as opposed to a psychiatrist) might be able to help here.

2: I have never, personally, wanted to die. I am happy with my life and while I certainly have been tired, somewhat depressed even (but not overly so) and in a bleak mood I really always wanted to keep on living. That being said, I can very easily imagine situations where I would, in the future, like to die. (A long, painful, terminal illness for instance, certain disabilities, or if I for instance for whatever eason took a significant hit to my mental faculties). I find it a reassuring thought that I could fairly easily end my own life if I wanted to. Not that I would ever do so on a whim.

3: This is the big one. I feel medical ethics needs to evolve to a point where the right to make (well informed, logical) decisions (by a person who is not insane) is the absolute highest right, not only on paper but also in practice. The medical community needs to fundementally change (see my earlier responses in this thread), but if and when it does I think this issue will come to the forefront fairly rapidly.

Well, yeah. There are frauds out there, no doubt, which makes the whole subject an intellectual quagmire. But that doesn't mean that everyone's a fraud. And no medium is perfect either, even though many people expect it for some reason I can't really understand.

The scientific analysis of the claims of mediums merely tries to establish whether the knowledge they claim to gather from their sessions surpasses that of chance (that is, guesses). And for some mediums, there's unequivocal proof of the fact that guesses alone cannot account for the information they have transpire.

Source. Read the (editorial) reviews before you dismiss it out of hand. This guy is a serious academic and so is the people praising that book. If you want something more accessible, I recommend this blog's articles on mental mediumship.

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"Depression is an illness that always results from thoughts that are distorted in some way."

— Dr. David Burns from the book Feeling Good

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Dr. David Burns - FEELING GOOD - TED Talk:

https://youtu.be/H1T5uMeYv9Q


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Dr. David Burns - What Is Depression (and How To Cure It) AUDIO:

https://youtu.be/33G1Aue4cP8

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Checklists & info on 'COGNITIVE DISTORTIONS' that twist our thinking:

https://s3.amazonaws.com/cbt-therapy/Cognitive-Distortions.pdf

http://www.smartrecovery.org/resources/library/Articles_and_Essays/Rational_Thinking/Cognitive_Distortions.pdf

https://www.apsu.edu/sites/apsu.edu/files/counseling/COGNITIVE_0.pdf

http://overcomingthedarkness.com/Articles/Cognitive%20Distortions.pdf

http://campusmindworks.org/downloads/cognitivedistortion.pdf

http://psychcentral.com/lib/15-common-cognitive-distortions/

https://www.anxiety-videos.com/wp-content/uploads/2016/02/Top-10-thought-distortions.pdf

http://www.goodtherapy.org/blog/20-cognitive-distortions-and-how-they-affect-your-life-0407154

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BURNS DEPRESSION INVENTORY/CHECKLIST (2-page PDF):

https://s3.amazonaws.com/happy-stuff/Depression-Inventory.pdf


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READ THE BOOK

FEELING GOOD: The New Mood Therapy - The Clinically-Proven Drug-Free Treatment for Depression

FEELING GOOD by Dr. David Burns is the #1 most recommended book for DEPRESSION by psychiatrists and psychologists. More than 5 million copies in print!

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FEELING GOOD - ORDER:

https://www.amazon.com/Feeling-Good-New-Mood-Therapy/dp/0380810336

THE FEELING GOOD HANDBOOK - ORDER:

https://www.amazon.com/Feeling-Good-Handbook-David-Burns/dp/0452281326

These books are like therapy in a box!

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Watch a series of short VIDEOS covering each of the 10 COGNITIVE DISTORTIONS listed in David Burns' amazing self-help book for anxiety and depression, The Feeling Good Handbook:

https://www.youtube.com/playlist?list=PLiPvQMm5dFde_KeELu_pWbivkW5XywcFI

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SERIES OF ARTICLE SUMMARIES BASED ON THE BOOK, FEELING GOOD:

http://sourcesofinsight.com/feeling-good-book-nuggets/

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Feeling Good Together: The Secret to Making Troubled Relationships Work:

https://www.amazon.com/Feeling-Good-Together-Troubled-Relationships/dp/0767920821

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Dr. David Burns' website:

https://FeelingGood.com

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WATCH OTHER VIDEOS WITH DR. DAVID BURNS, A PIONEER IN COGNITIVE BEHAVIORAL THERAPY (CBT):

https://www.youtube.com/results?sp=EgIYAg%253D%253D&q=DR.+DAVID+BURNS

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Learn Cognitive Behavioral Therapy skills for preventing and coping with depression:


Cognitive Behavioral Therapy (CBT) SELF-HELP COURSE:


http://www.getselfhelp.co.uk/step1.htm



MOOD GYM - CBT SELF-HELP COURSE:

https://moodgym.anu.edu.au/welcome

The words of David Foster Wallace seem strikingly apposite.

>The so-called ‘psychotically depressed’ person who tries to kill herself doesn't do so out of quote ‘hopelessness’ or any abstract conviction that life's assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire's flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It's not desiring the fall; it's terror of the flames. Yet nobody down on the sidewalk, looking up and yelling ‘Don‘t!’ and ‘Hang on!’, can understand the jump. Not really. You'd have to have personally been trapped and felt flames to really understand a terror way beyond falling.

I had always assumed they were inspired, in part, by the events of 9/11, but a quick Google search reveals the source of quote is his 1996 novel [Infinite Jest] (http://www.amazon.com/Infinite-Jest-David-Foster-Wallace/dp/0316066524)

Are you familiar with Thomas Joiner's work? Although his goal is a bit different in that he's looking for unifying characteristics among suicidal individuals (and he may well have found them), he starts from historial models including Durkheim's, and dervices a model with 3 necessary and sufficient risk factors for high risk of death by suicide. He then explores how the model fits the various (apparently) different categories of suicidal person. As I recall, he does discuss Durkheim's categories pretty thoroughly in his first mainstream book and in his review for clinicians.

I actually use his model as the foundation for the talking tips post the we pulled together for the /r/suicidewatch community; the last part of that has a very quick overview of his model.

His work actually validates a lot of things that have become standard practice at suicide hotlines (I answer one IRL) because the empirical data has shown them to be uniquely effective, such as focusing primarily on rapport and interpersonal connection.