Depression due to brain lesion?

I feel like I’m at my wit’s end.

I’m a 26 year old female, Caucasian, overweight. My labs (CMP, CBC, TSH) are WNL.

I’ve suffered with major depression for roughly 7-8 years. Tried therapy a few times, never did much for me. A year and a half ago, I finally couldn’t take it anymore, and sought pharmaceutical intervention. Nothing I’ve tried has worked. My progression has been sertraline to citalopram to duloxetine to bupropion at therapeutic doses. The only one I didn’t give at least 3 months was sertraline due to intolerable side effects. I’ve tried augmenting with fish oil, b vitamin complex, women’s multivitamin, vitamin D2 50,000IU, vitamin D3 6000IU, and daily 15mg methylfolate. I’ve lost 30 pounds by regular exercise (which has done nothing to improve my mood. I don’t think my body knows what endorphins even are) and improved diet. My depression continues to get worse. I have trouble concentrating, I feel like everything is muffled, I have no motivation, every moment of every day is like trying to wade through molasses. I sleep 9-12 hours at a time if I don’t have to set my alarm the next day, and that’s with a two hour nap during the day. My work and school has suffered significantly.

I don’t know if this is relevant to this, but I’ll include it: I also have compulsive tongue chomping, a repetitive grimace from time to time, wrist rolling, and this almost shrug-like movement I do from time to time. People have pointed it out to me that I have these weird ticks. Sometimes it feels like I’m uncomfortable in my skin, like I’m trying to adjust my skin to be more comfortable, and the ticks somewhat alleviate that. I’m sure that’s some kind of weird neurological thing.

Anyway, at the same time as trying to get my depression under control, I saw a neurologist for some bothersome facial neuralgia, which she diagnosed as trigeminal neuralgia. She had me get an MRI.

She wrote in my report that there was a “wedge-shaped gliosis in the right frontal lobe.” But when her MA called, I was told there were no problems, everything looked normal. When I brought up what the neurologist wrote, she then offered me an appointment to follow up. When I saw the neurologist, she showed me my MRI, which did show a solid white circle in the frontal lobe that I would very loosely guess to be the size of a quarter (I don’t know much about neurology, so pardon my layman’s terms). However, the neurologist said to me, “if you were older, I wouldn’t have even mentioned it, but given your age...it could be nothing, but there is a concern it’s a slow growing cancer. Make an appointment for a follow-up MRI in a year.” And sent me on my way. I’ve been trying to get the follow-up MRI, still waiting for her to put in the order.

I don’t like feeling like I’ve been brushed off, and I get the feeling that she isn’t taking me seriously. I guess my question is...could my depression and whatever is in my frontal lobe be linked? And should I continue to see this neurologist? Is a spot in the brain ever normal?

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