Too Real For Facebook

 Warning: the following is pretty much a remix of the immediately previous post here.  I had originally posted it to Facebook late one night, and woke up a few hours later regretting it.  So I hid it on FB, but here it is, for no good reason.  Pointless update follows.

[begin deleted FB post]
Depression, if that is what this is, is a confusing thing. I never thought that I would not feel like singing, but that is where I am now. Singing had been the best medicine for most of my life, especially when I discovered how much better it was with an audience, and even better with the support of a live band. The last time I tried I was terrible, and it was humiliating. I keep intending to try again, but I am reaching the point of accepting that I should never try again. I have tried pretty much literally every purported treatment, both conventional and unconventional, except ECT, Ketamine, Psilocybin, and LSD. I have been trying self-acceptance instead of escalating to yet another treatment, but it isn't working. I am so broken inside in so many ways, and I always have been, but now I am also old and tired, physically weak and in pain. All I want to do is to believe that I can sing again, but I can neither sing nor believe.
 [end deleted FB post]

And now the pointless update and inevitable reiterations.

Given that the choices are suffering, suicide and treatment, I choose to suffer through the remaining untried treatments, of which the above post omits one highly dubious option: MDMA.  There is a legal Ketamine treatment facility in the area, but it is very expensive and very likely not covered by insurance.  I don't know of a reliable source for correctly synthesized LSD or MDMA, and outside of clinical trials or eventual legal treatment, finding either seems hazardous and unlikely.  Besides, my experience with big-pharma anti-depressants makes me more than a little wary of synthetic psychoactive compounds.  Anybody wondering why I'm not talking about CBD or THC, I have already eliminated those from further consideration. CBD is very likely at best a placebo, and THC has no history of efficacy in treatment of depression. Similarly, narcotics are not under consideration, as they are at best distractions from, but certainly not direct treatments for my problems, and pose numerous obvious risks. 

So, there is both clinical and anecdotal evidence that Psilocybin is a possible effective treatment, often compared to LSD in both efficacy and theorized mechanism, but has the advantages of not requiring complex synthesis and being readily available.   Positive results have been reported from a single substantial dose providing sustainable improvement after the initial experience, and positive results have also been reported from periodic "micro-dosing".   I propose that I might try the first, and if later deemed worthwhile, the second method. 

If that doesn't work, I think I will skip Ketamine, all known risks and possible benefits considered, which leaves me with ECT (Electroconvulsive Therapy), if it is considered safe enough given my compromised cardiac condition.  ECT has a bad popular perception, but a surprisingly good clinical history of safety and efficacy.  Nonetheless, I hope Psilocybin will "magically" improve my condition so that I no longer have to consider either ECT or suicide.  

Suicide remains extremely unlikely, as I perceive my condition and prognosis at present.  Life will end soon enough one way or another without my assistance.  Bringing it about abruptly by my own action would selfishly impose considerable temporary distress and inconvenience on my immediate family.

I may have mentioned earlier, but just to make it clear here, after the failure of TMS (Transcranial Magnetic Stimulation, likely just a very elaborate placebo), I resolved to try simple acceptance, and to relieve myself of the debilitating cycle of hope and disappointment.  For long stretches of mere numb existence it works, but then there are days and nights when it doesn't.  My emotional landscape consists of alternating absence*, sadness, and anger.  Of these, I find anger the most intolerable, not just because it is pointless but more because it is unpleasant for those with whom I interact.  I have no right to subject anyone to my irrational, unproductive anger.  Being merely useless is bad enough.  I consider the pursuit of any available reasonable further treatment to be something of a duty, more towards others than myself.

*"absence" as I use it here is a difficult state of being to describe.  Time passes, I perform the bare minimum of daily required functions, and I am in many ways not entirely conscious.  I may putter about ineffectually on various projects, gleaning no actual progress or results, frequently leaving one effort in scattered pieces and simply taking up another new or previously abandoned effort.  Most of my time is actually spent trying to remember what I had been doing, or trying to find the fragments of unfinished work I had previously abandoned.