The Great Battle For A New Psychiatrist started last January when my clinic "did not renew the contract" of my last one. They pulled out of retirement my previous psych for six months part time, but he wasn't willing to keep working forever, and in that six months, they failed to hire a new doc. So, since June, I've been without a psychiatrist and they haven't hired yet.
As a result, I've been actively looking for someone who is taking new patients and will see me in under six more months. I need prescriptions, and the clinic won't refill things written over six months ago, so this was getting to be a crisis. The last time I took my ADHD son in to see HIS psych for med checks, I asked his psych's office if he was taking new patients. He isn't: he's retiring at the end of the year. But another doc in the office IS. Fine; I scheduled an appointment with him.
I was nervous last week when I went in; I admit it. I have a very long psych history though it isn't very interesting. I take narcs for chronic pain relief, and this doc's intro letter said he likes to treat "the whole patient" not just use meds, so I was afraid that he would start off by trying to take me off my meds.
He didn't, at least in the first 2-hour intake visit, which was supposed to be 75 minutes. However, I had already signed a release for my psych records and in addition, he DID want records from my PCP, my pulmonologist, rheumotologist, and dermatologist! I'm surprised, but it's ok with me. He can check and see if my stories are true; they all are.
Also, over the years I've found that I virtually always have to carry information between my specialists. They don't communicate with each other. If this doc is willing to read my health history, it's that far to the good. I doubt he will (he doesn't know what he's asking for), but if he does, bully for him. What won't work is if he starts second-guessing my other docs.
So we'll see. He's a counselling psych -- an oddity -- but that's ok with me, too. For over a decade I've been limited to 15 minutes every 3 months for med checks, even when I was in crisis. I'd rather have someone I can actually talk to enough to tell him where I really am in this weird process called living. Assuming he doesn't just look at my records and tell me that I need to be on fewer drugs and imagine myself lying on a warm beach, feeling my toes relaxing as I sink into the sand ....
Been there, done that. I need meds, thanks.
Have a nice day.
Showing posts with label depression. Show all posts
Showing posts with label depression. Show all posts
Tuesday, September 30, 2008
Monday, September 15, 2008
Deep Brain Stimulation: hope for treatment-resistant illnesses?
An article appeared in my local newspaper this weekend written by Judith Graham of the Chicago Tribune entitled "Deep brain stimulation offers hope to people with treatment-resistant illnesses". I was intrigued.
Basically, it said that deep brain stimulation is a technique in which doctors drill two dime-sized holes in the skull and guide small electrodes into two brain sites the size of tic tacs or small green olives. A battery pack is then implanted at the base of the skull in the back of the neck, and the electrode locations become the targets of pinpointed electricity. The current from the batteries tamps down brain circuits that are firing abnormally or revs up circuits that are underactive, experts hypothesize.
It is already in use to treat Parkinson's disease, but is in trials for other uses, such as treatment-resistant depression, OCD, epilepsy, traumatic brain injury, Alzheimer's disease, and chronic pain. In some cases, the results are little short of miraculous. One patient had been suicidally depressed for four years before the surgery and now enjoys a depression-free life, but it didn't happen overnight. For the first six months he felt nothing and was devastated. The doctors had to tinker with his implants until they got just the right settings. Then he woke up and realized "the pain, the fear and the anxiety were gone".
I know I could live with that. Deep brain stimulation is still considered a treatment of last resort for those for whom conventional treatments have failed, but in the U.S. that includes approximately 2 million depressed patients per year. It is expensive, costing approximately $150,000 per patient. There are potential side effects, as well, including problems related to medical hardware, brain bleeds or hemorrhages, infections, post-surgery seizures and headaches, pain and severe mood fluctuations, reports suggest. Not something to enter into lightly. But after twenty or more years of suffering, if I had the possibility in front of me of being WELL?
I know I have virtually no shot at being included in a trial because of my other medical conditions ... but I sure would take my chances.
Have a nice day.
Basically, it said that deep brain stimulation is a technique in which doctors drill two dime-sized holes in the skull and guide small electrodes into two brain sites the size of tic tacs or small green olives. A battery pack is then implanted at the base of the skull in the back of the neck, and the electrode locations become the targets of pinpointed electricity. The current from the batteries tamps down brain circuits that are firing abnormally or revs up circuits that are underactive, experts hypothesize.
It is already in use to treat Parkinson's disease, but is in trials for other uses, such as treatment-resistant depression, OCD, epilepsy, traumatic brain injury, Alzheimer's disease, and chronic pain. In some cases, the results are little short of miraculous. One patient had been suicidally depressed for four years before the surgery and now enjoys a depression-free life, but it didn't happen overnight. For the first six months he felt nothing and was devastated. The doctors had to tinker with his implants until they got just the right settings. Then he woke up and realized "the pain, the fear and the anxiety were gone".
I know I could live with that. Deep brain stimulation is still considered a treatment of last resort for those for whom conventional treatments have failed, but in the U.S. that includes approximately 2 million depressed patients per year. It is expensive, costing approximately $150,000 per patient. There are potential side effects, as well, including problems related to medical hardware, brain bleeds or hemorrhages, infections, post-surgery seizures and headaches, pain and severe mood fluctuations, reports suggest. Not something to enter into lightly. But after twenty or more years of suffering, if I had the possibility in front of me of being WELL?
I know I have virtually no shot at being included in a trial because of my other medical conditions ... but I sure would take my chances.
Have a nice day.
Thursday, September 11, 2008
Managing Cyclic Depression
Most people who don't have clinical depression have no idea how totally disabling it can be. It's easy to say "I'm depressed" when what one means is "I'm sad". They're not the same thing -- ask anyone who has ever been truly depressed. Being sad makes you want to cry. Being depressed sucks out your soul, makes you apathetic, makes you want to die, even when you can look at your life objectively and realize that there is no legitimate reason for feeling that awful. I have looked at my doc when I was off my meds because I was pregnant and said "I just want to die and I know there is nothing wrong with my life. But give me my drugs back and in two weeks I will be fine." And I was. That is depression, not sadness.
I have struggled with clinical depression since my childhood, as my parents did before me, and have taken medication for most of the past twenty years. It takes a cocktail of meds to keep me stable and, for the most part, high-functioning and even content. I am a testament to big pharma. Better living through chemicals. I accept this.
I have "severe treatment-resistant cyclical clinical depression", which means basically that I have it badly, that most drugs don't work on me and that that is why it takes a cadre of them to keep me stable, and that my depression gets worse in more or less predictable cycles. In my case, I can almost post on my calendar in advance that I will have a hard time in March-April and around November, and then I'll pull out of it again to some extent. Various psychs have posited the theory that this is SAD (Seasonal Affective Disorder), but that doesn't make sense, since SAD is linked to sunlight deprivation. If it were SAD, I would be, well, sad from October or November when it gets grey UNTIL March or April when it gets sunny again. I would not be fine from December through February while it's grey. Nope: it's cyclical, and those months are my two downward cycles, more or less.
Does anyone know why? Not that I know of, least of all me. I could make up answers, but that's what I'd be doing. I've had these cycles since childhood.
Nobody I've ever met really understands cyclical depression. All they can do is give me drugs to keep me stable and hope those drugs get me through the two worst periods of the year in relative stability, knowing I will still have a bad time of it for a while. The rest is up to me, and since I've had enough practice, I should be good at it, right?
It does actually help that I recognize the onset now and I know what is happening. I know that the SX's will pass in time, and even about when. That puts light at the end of the tunnel, although the end point may seem very far away, and that is hard. It's even hard knowing I'm coming up on one of them. Does that cause it? I don't think so. I got away without this year's March-April cycle completely, but that was unusual.
What can you do when I'm down? If you are another depressive, by all means share that with me if you're willing to, along with your best wishes and coping mechanisms. I will be warmed to know that someone understands how awful it is.
But realize that you don't HAVE to know how I feel to comfort me. On behalf of all truly depressed people everywhere, I beg those of you who have never experienced this not to believe you know "just how it is" because you were really down in the dumps once. I'm sure you felt bad; I'm sorry. But you still don't have a clue. It does NOT help to tell me just to "cheer up and everything will be fine". This makes me unreasonably angry: why would anyone assume that I'm enjoying this and wouldn't change it if I could? I LIKE huddling in my bed all day with suicidal thoughts, dragging myself out just long enough to drive my kids to school and make sure they're fed? Um ... maybe not? Maybe I'm actually doing the best I can just to keep going at all under the circumstances?
If you want to be supportive of me even though you don't understand why I'm like this, don't assume you could handle this better than I am. I'm not exaggerating how bad things are in MY world: that's the nature of the illness. That's my reality. Instead, bring us a casserole so I don't have to cook dinner, offer to bring my kids home from school one day or take them after school one day, pick up milk and bread at the grocery store when I can't make myself get dressed, tell me you love me (that always helps, even if I can't express that it does). But please, tell me you know how I feel only if it's true.
And please, don't judge me. I didn't choose this. I'm not crazy, I'm depressed: there is a difference. This is a disease with an underlying genetic basis which I got from both parents. Unlike them, I seek professional help and I take my meds. It is not a moral issue, and I would not be well if I'd just "have a more positive attitude" or "more self-control". If you wouldn't criticize a diabetic, don't criticize me. I'm doing my best.
To all of my brothers and sisters out there suffering silently, with or without meds, all year, keep fighting. One day they will unlock this, and we will be free.
Have a nice day?
I have struggled with clinical depression since my childhood, as my parents did before me, and have taken medication for most of the past twenty years. It takes a cocktail of meds to keep me stable and, for the most part, high-functioning and even content. I am a testament to big pharma. Better living through chemicals. I accept this.
I have "severe treatment-resistant cyclical clinical depression", which means basically that I have it badly, that most drugs don't work on me and that that is why it takes a cadre of them to keep me stable, and that my depression gets worse in more or less predictable cycles. In my case, I can almost post on my calendar in advance that I will have a hard time in March-April and around November, and then I'll pull out of it again to some extent. Various psychs have posited the theory that this is SAD (Seasonal Affective Disorder), but that doesn't make sense, since SAD is linked to sunlight deprivation. If it were SAD, I would be, well, sad from October or November when it gets grey UNTIL March or April when it gets sunny again. I would not be fine from December through February while it's grey. Nope: it's cyclical, and those months are my two downward cycles, more or less.
Does anyone know why? Not that I know of, least of all me. I could make up answers, but that's what I'd be doing. I've had these cycles since childhood.
Nobody I've ever met really understands cyclical depression. All they can do is give me drugs to keep me stable and hope those drugs get me through the two worst periods of the year in relative stability, knowing I will still have a bad time of it for a while. The rest is up to me, and since I've had enough practice, I should be good at it, right?
It does actually help that I recognize the onset now and I know what is happening. I know that the SX's will pass in time, and even about when. That puts light at the end of the tunnel, although the end point may seem very far away, and that is hard. It's even hard knowing I'm coming up on one of them. Does that cause it? I don't think so. I got away without this year's March-April cycle completely, but that was unusual.
What can you do when I'm down? If you are another depressive, by all means share that with me if you're willing to, along with your best wishes and coping mechanisms. I will be warmed to know that someone understands how awful it is.
But realize that you don't HAVE to know how I feel to comfort me. On behalf of all truly depressed people everywhere, I beg those of you who have never experienced this not to believe you know "just how it is" because you were really down in the dumps once. I'm sure you felt bad; I'm sorry. But you still don't have a clue. It does NOT help to tell me just to "cheer up and everything will be fine". This makes me unreasonably angry: why would anyone assume that I'm enjoying this and wouldn't change it if I could? I LIKE huddling in my bed all day with suicidal thoughts, dragging myself out just long enough to drive my kids to school and make sure they're fed? Um ... maybe not? Maybe I'm actually doing the best I can just to keep going at all under the circumstances?
If you want to be supportive of me even though you don't understand why I'm like this, don't assume you could handle this better than I am. I'm not exaggerating how bad things are in MY world: that's the nature of the illness. That's my reality. Instead, bring us a casserole so I don't have to cook dinner, offer to bring my kids home from school one day or take them after school one day, pick up milk and bread at the grocery store when I can't make myself get dressed, tell me you love me (that always helps, even if I can't express that it does). But please, tell me you know how I feel only if it's true.
And please, don't judge me. I didn't choose this. I'm not crazy, I'm depressed: there is a difference. This is a disease with an underlying genetic basis which I got from both parents. Unlike them, I seek professional help and I take my meds. It is not a moral issue, and I would not be well if I'd just "have a more positive attitude" or "more self-control". If you wouldn't criticize a diabetic, don't criticize me. I'm doing my best.
To all of my brothers and sisters out there suffering silently, with or without meds, all year, keep fighting. One day they will unlock this, and we will be free.
Have a nice day?
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