Hi, I’ve been taking antidepressants for about a year and a half. During the first half of this period, I was on Lexapro (it worked well for the first few months, but then it stopped being effective). Afterward, I switched to Trintellix, but it didn’t work for me either.

Could it be that antidepressants don’t work for me because I occasionally used drugs while on treatment? (I occasionally used cocaine, MDMA once, and drank alcohol every weekend.)

I’m currently struggling with: • Derealization (feeling like nothing around me is real). • OCD. • Visual disconnection (feeling like my vision isn’t “real” or clear). • Poor memory and concentration. • Emotional numbness. • Extreme apathy.

Is it possible that I’ve damaged my brain and my serotonin receptors no longer respond to antidepressants?

I’m really worried about the things I did in the past. I can’t stop thinking that I ruined my life and will never be the same as I was before. However, I wonder if this is just a symptom of my OCD and retrospective bias.

I know I can’t change the past, but these thoughts keep haunting me. Any advice or similar experiences would be greatly appreciated.