Hello...I have struggled with major depression since I was 18. I am now 49. I've tried nearly every medication on the market which at various times, have provided limited periods of relief only to eventually become ineffective. Four years ago, my psychiatrist put me on Parnate (an MAOI) and Adderall as a last resort before exploring ECT or TMS Therapy. To my amazement, this combination has kept me relatively stable...Not jumping for joy, but functional. I still struggle with emotional regulation but I don't feel like I'm confined to the hopeless, bottomless pit that severe depression feels like to me. This is my dilemma. Four years ago, I experienced early menopause. Initially, I noticed an increase in breakouts on my chin and cheeks. As time progressed, however, those mild breakouts became a case of severe cystic acne that appears to be treatment resistant to EVERYTHING. I've been on every imaginable antibiotic and topical for the last three years. In addition to the 'sophisticated pharmaceuticals', I've tried sulfur, tea-tree products and a variety of homeopathic products. I've wanted to take Accutane for quite some and I most certainly am a candidate however the risk of enhancing my depression truly frightens me. I've heard that depression can be a side effect of Accutane but I wonder how it effects an individual who already suffers from severe depression? To make matters more confusing, my PCP says absolutely not, my dermatologist doesn't have much of an opinion, my current psychiatrist is either on the fence or simply not knowledgeable on the subject, but my psychiatrist of seven years, who I only recently stopped seeing, was adamantly opposed. As I ponder what to do, my skin which was once quite nice, is continually inflamed, extremely painful and becoming riddled with scars. I have Kaiser and asked them several months ago if they offer any kind of light therapy but they told me that the conventional treatments they offer, (topicals and antibiotics), are just as effective. I filed a grievance to be seen at UCSF, Stanford or anywhere where cystic acne is a specialty. I explained that I suffer from severe depression and that many have adamantly asserted that I unfortunately am not a candidate for Accutane, the logical treatment. My appeal was denied. The Head of the Dermatology Department said that while there have been studies indicating that Accutane can cause depression, the 'jury is still out.' I don't feel he must have looked at my medical record as it quite clearly indicates that depression has been a life-long struggle which finally led me to apply for SSDI. I am currently debating whether to take the grievance to the next level or simply see another dermatologist within their department. In any event, I am new to this web-site but think it is wonderful. If anyone has an opinion on my situation, I would be extremely appreciative. Apologies for a very long-winded post. Many Thanks.