Treatment Resistant Depression: Curbing Expectations
This is the second entry in a series about bearing the invisible weight of mental illness or trauma. Today, I want to talk about the journey I took to finding treatment. I imagine it’s not too different from yours.
I think a commonality that all of us who come to treatment share is that we’ve learned to curb our expectations. As a seeker of mental health treatment, you’re likely already familiar with the existing tools medical science has to offer in treating depression, trauma, or other invisible conditions. After trying enough medicinal solutions to combat depressive symptoms and seeing no relief, the promise of trying something new can seem either pointless at best or disingenuous at worst.
I served in the military for years, and so my health care comes from the VA. Visiting a clinic or medical center for any reason in the VA system requires that a patient fills out a pre-screener to catch potential serious issues, like chest pain or shortness of breath. Added to that screener is a set of mental health questions. Have you experienced persistent feelings of hopelessness? Do you feel that life has no meaning? Have you had serious thoughts of doing harm to yourself? I think this is the point where the experiences of a person without an invisible weight and a person who shoulders one every day start to diverge. These are normal concerns for a medical provider, and I’m truly glad that the VA is doing something to try to address the problem of mental conditions, but they’re meant to catch drops of rain. The problem comes when you’ve already tried everything, and that rain catcher is standing in the way of a flood. The VA always helpfully asks me if I’d like an appointment with psychiatric care if I ever answer those questions in the affirmative. I politely decline, even if the general practitioner in front of me looks unnerved and uncomfortable.
They don’t know that I’ve already tried everything they can offer me.
Maybe You Should See a Therapist…
The weight of depression would be serious enough all on its own, but with it comes a different sort of demon: isolation. People around you genuinely want to see you get better when they watch you suffering, but it becomes easy for us to perceive the point at which their enthusiasm turns to skepticism. Are our friends and family wondering somewhere inside whether we’re trying hard enough to solve our problems? After enough of a struggle, shouldn’t we have made more progress? I don’t know about you, but I’ve heard the same things over and over again for the past thirty years: Have you ever thought about getting on medication? Maybe you should see a therapist. You know, my sister is reading this really great book about how your thoughts control your reality, and I think you could make a real change in your life if you just started seeing things differently. I can recall so many occasions on which I wanted to get angry at those sort of suggestions, even if they come from a good place. These comments remind me that it’s strangely difficult for loved ones to understand what I’m going through, regardless of their good intentions.
I sometimes wonder if there’s something about depression, or any other invisible condition, that unsettles people on a very deep and personal level. Whenever I’m trying to center myself and remember that I’m not to blame for the cause of my conditions, I remind myself that it wouldn’t be so hard to remember that if I replaced ‘depression’ or ‘trauma’ with ‘diabetes’ or ‘cancer’. No one would talk to a cancer patient of thirty years and ask if they’ve considered going to the hospital, or if they’ve ever thought about focusing on staying alive. The isolation that comes from misunderstandings and continued struggles can be just as damaging as living with the symptoms that treatment is meant to alleviate. If you’re here, I think that you’ve experienced this for yourself. There’s no difference between your struggles and someone with a condition that their loved ones can see. You’re just a horse of a different color, no matter how blind everyone around you may be.
I’m talking about this today because I wanted to remind you – and myself – of where I was when I came to ketamine treatment. I was at the end of my rope. I think I’d tried just about every antidepressant and stimulant my doctors could think to prescribe me, and the fact that they didn’t solve my problems was only half the story. Waiting six weeks for an SSRI to take full effect is the equivalent of putting your life on hold for a month and a half. Seeing the brutal side effects of these drugs take their toll on your emotional state, your desires, or your physical fitness can be just as damaging as the condition you’re trying to lift. Worst of all, what’s supposed to be left for you if you’ve tried and exhausted all of those possibilities? I wasn’t getting better. I was watching myself get worse, and each time I tried something new, more and more time was slipping away. I wasn’t sure if I could ever get better.
Ketamine Therapy: Too Good to Be True?
In March of 2016, I had a choice to make. After scouring the internet for something – anything – that might be able to help me, I’d learned that a drug called ketamine was being used to treat major depressive disorder with incredible results. At the same time, I was already planning a round of Electroconvulsive Therapy, or ECT. For those of you who aren’t familiar with ECT, it’s exactly what it sounds like: electric shocks delivered to your brain. For those of you who knew that, I think it’s a sad commentary on our ideas of health care that we’d consider this to be a viable option for those who have suffered under the darkness of an invisible weight. Patients see a 50% success rate, and if antidepressants aren’t effective, a 75% chance of relapse. Potential side effects of ECT can include permanent loss of long-term memories! I didn’t like anything about any of that, but what other choice did I have?
Ketamine seemed too good to be true. A seventy-percent response rate? Radical improvement within 24-48 hours? No known side-effects and long-term options? I couldn’t be reading that right. I decided I owed it to myself to get some answers in person, and canceled my electroshock therapy in favor of a ketamine consultation hundreds of miles away. I had nothing left to lose, and if you’re at the end of your rope, then maybe you have nothing to lose either. Maybe it’s your loved one who has been struggling, and you’re desperate to find some real way to help them. Maybe you’re somewhere in between, and you just want to know more before you open up that suit of armor to a new possibility. Stick around. Next time, I’ll talk about how ketamine treatment saved my life.
More About Allen
This is Part II in Allen’s ongoing series on his experience with finding a depression treatment that works. Allen, a veteran of the Air Force, is proud to share his story with others in an effort to build connections in the mental health community and advocate for finding effective treatments to help others get well. Allen is a patient with Actify Neurotherapies and has been empowered in his path to depression management.
If Allen’s story resonates with you and you’re curious about the treatment options Actify Neurotherapies offers, don’t hesitate to reach out to one of our Patient Services Specialists. We are available day or night to learn more about your story and to help you decide if ketamine therapy is right for you. You can reach us at 888-566-9774 or email us.