Where are you located? What are the symptoms? Many times, depression is a symptom of a deeper problem, especially if lifelong.
What do you mean specifically by "I was able to sleep when I wanted to"? You have profound insomnia? Any serious enough sleep disorder will give you depression, and if sleep is an issue - address that first. Sleep medicine is quite involved, and often if it's something subtle you'd have to travel to get expert advice. Stanford is a pretty good sleep medicine centre, both in respiratory and circadian disorders.
As for the safe treatments: there are now clinics that offer ketamine infusions (nearly instant remission even in very severe cases), and psilocybin, under medical supervision.
Both are fairly safe, and have no discontunation/withdrawals symptoms. You will be screened if it's appropriate for you, and it will always be administered under medical supervision the entire time. Ketamine is extremely successful, most in nearly instant remission that least at least a week or two, but the effects do not last forever, and most patients require ongoing treatment. At least you may know what it feels like to be not-depressed.
SSRIs are fairly safe in hands of a competent and most importantly caring prescriber. SNRIs however, at least anecdotally, many prescribers no longer use. Look for someone who truly cares and wants to help. Discontiuation is real, but any competent prescriber will know how to taper it, often a compounding pharmacy is used.
You should have any and all thyroid issue ruled out definitively, all nutritional deficiency ruled out, all allergies/intolerances, no matter how seemingly insignificant eliminated. Full in-lab polysomnography and sleep endoscopy should be done to rule out any sleep issues. Actigraphy might be helpful too, if you have a circadian disorder.
The best proven au-naturel anti-depressants is lots of exercise and lots and lots of social interaction. Did they help?
If not, and you have so called endogenous depression, some sort of medication will be more than likely needed, but in such cases SSRIs will be tried and are often found insufficient. You may need MAOIs, most of the time Parnate will be used. It is safe, but it comes with absolute contraindications to a few foods, and requires a dedicated diet (no cheese, and no fermented foods, not that difficult to maintain), and you'd need someone with an experience using this medication, it's a bit of an orphan drug at this point. I'd try ketamine or psilocybin first.
I never heard of anyone with lifelong depression recover with therapy alone, usually a combination of medication+therapy, and very, very often an underlying condition was found too.
Both are fairly safe, and have no discontunation/withdrawals symptoms. You will be screened if it's appropriate for you, and it will always be administered under medical supervision the entire time. Ketamine is extremely successful, most in nearly instant remission that least at least a week or two, but the effects do not last forever, and most patients require ongoing treatment. At least you may know what it feels like to be not-depressed.
SSRIs are fairly safe in hands of a competent and most importantly caring prescriber. SNRIs however, at least anecdotally, many prescribers no longer use. Look for someone who truly cares and wants to help. Discontiuation is real, but any competent prescriber will know how to taper it, often a compounding pharmacy is used.
You should have any and all thyroid issue ruled out definitively, all nutritional deficiency ruled out, all allergies/intolerances, no matter how seemingly insignificant eliminated. Full in-lab polysomnography and sleep endoscopy should be done to rule out any sleep issues. Actigraphy might be helpful too, if you have a circadian disorder.
The best proven au-naturel anti-depressants is lots of exercise and lots and lots of social interaction. Did they help?
If not, and you have so called endogenous depression, some sort of medication will be more than likely needed, but in such cases SSRIs will be tried and are often found insufficient. You may need MAOIs, most of the time Parnate will be used. It is safe, but it comes with absolute contraindications to a few foods, and requires a dedicated diet (no cheese, and no fermented foods, not that difficult to maintain), and you'd need someone with an experience using this medication, it's a bit of an orphan drug at this point. I'd try ketamine or psilocybin first.
I never heard of anyone with lifelong depression recover with therapy alone, usually a combination of medication+therapy, and very, very often an underlying condition was found too.