Saturday, 1 October 2011

Treatment options following Psych appointment

So last Tuesday I had a Psychiatrist appointment, the last one being in July due to my health insurer no longer paying for my medical treatment.
Let me explain, I have been feeling REALLY bad - one of my GPs has been seeing me every two days to check I am still alive and to support me towards my psych appointment.
The kind of things that have been happening have included feeling suicidal, crying a lot, not sleeping (well that's been ongoing since April), heavy body feeling, no energy, feeling empty and imagining conversations have happened when they haven't, imagining experiencing things when I haven't, poor memory - I could go on but don't want to bore you.
Anyway, Dr I said that what I was experiencing was typical of deep depression and considering I have this, plus a mood disorder (daren't ask him which one), plus the stress of no job and the stress of a relationship split have all contributed to my current state of mind.
We went on to further discussion about treatment options, including another medication change (number 5 I think) and he told me not to worry, there are another 81 medications I can try (he has a sense of humour like mine).  So he has reduced the Venlafaxine to 150mg/day and added Cipralex 10mg/day.  Plus the Seroquel at night (100mg) and Lamictal 100mg twice daily.
Then, and this was the shock (!), he asked me if I would consider ECT.  My first thought was, "bloody hell, I really am that bad" and promptly told him NO, NEVER.  he talked through how it works and encouraged me to do some research and that he had seen good results when he was doing ssome training in America and that it might prompt the medication to work in the future.  With treatment resistant depression and with me, the meds work for a certain period and then I become "tolerant" to them.
I sighed, cried and then said if this round of meds doesn't work then I might consider it.
He then suggested I went as an inpatient for three months.  Problem is my health insurer.  And I think it's a good idea to go back to the bin for a while. Am considering going back to the UK and trying to get admitted there if I can't here.
All a bit of a heavy appointment and too much to think about.  However, I am feeling a bit lighter today and haven't reacted to the new medication yet, but it would probably help if I stopped getting roaring drunk every night (starting on the Tuesday by meeting up with a good friend of mine).
My BBF will be phoning me later to persuade me to come and live with her in the UK.  A friend I met up with yesterday also told me to go back as I "have no life here and it isn't doing me any good".  Yeah, she always makes me feel better....not.
So I will be on holiday in the UK to see friends/family from Wednesday to the last week of October - thinking time and decisions to be made.

3 comments:

  1. Hi there,

    I hope you don't mind me commenting as I've only just found your blog.

    Can't believe that any doctor tries it on with patients about ECT these days... and making it sound scientific and credible by suggesting you do your own research too. Bunkum! Good on you for saying NO!

    But ECT does seem to be quite popular in CH... I have friends there who know about this - two quacks and three shrinks. They all admit that no-one still has any idea about what ECT really does medium to long term - at least not the way it is practised today, which they will argue is far more controlled and at a lower level of current than in the past. The confusion starts over how patients are measured: what aspect of mood, behaviour... time periods... the role of medication... It's such a minefield and nearly impossible to clinically test reliably because (like anything in mental health) so much of the data can be subjective.

    But for all the gas about how much "lighter" the treatment is, and how much more we understand the brain today, it still amounts to crazy science, despite claims that some patients benefit from it. Funny how many patients are only monitored in the weeks after treatment - not months or years on. That's not to say that these people start having brain meltdown or anything, but I know several who've had successive ECT who clearly describe an absence of emotion at normally very stressful or joyous events. Is THAT a cure for stubborn, unipolar depression? I'd rather ski, run marathons up the mountain passes or rock climb to force my body to squish out endorphins in my brain. Some people's noggins are better at it - yours and mine are probably not great at it. But there is strong evidence to suggest that you can actually encourage your brain to produce more endorphins over time when in physical training - and then, like a slow avalanche, it starts to gain its own momentum and you produce much more of the good stuff than you used to. At least it's one theory. When I'm suicidally depressed, the last thing I want to do is bugger off up some frigging mountain. Especially if I feel like I might fling myself off!

    Do take care - I totally agree over your cat. My boy has been the difference between life and death since he's been with me. He's lying down by my side as I type actually - like a rather short, but very warm draft excluder!

    X Clarissa & Lexi, the Bengal Cat
    www.justdifficult.com

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  2. Awww thanks Clarissa. It's really hard to get some objectivity over this and all I seem to get is "how do you feel about ECT being recommended" or "do your research" but not much in the way of actual clarity or answers to my questions i.e. WHY is it thought it works, HOW does it work, WHAT about the side effects. It's all a bit vague. The worrying thing is my family and friends in the UK are all for it (I don't think they really understand it, just see it as like taking another pill or like the Kudos of their friend/daughter being soooo ill that all she can have is ECT. MY friends and ex boyfriend in Switzerland are dead against it. My GP is reluctant and tells me to "do my research". Aaaargh! The research I have done shows 60/40 success rate, everyone who has had it has hated it, but for those where it "worked" they say it has "changed their life". I think the odds are pretty low to be honest. But I need to sort it now, while I am feeling well and stable otherwise I could agree to anything when I am in the depths again. All I can say is the meds are really working at the moment and it was only a month ago when I was verging on suicidal again.

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  3. Hi love,

    I'm really surprised your family are so gung ho about ECT - why not watch "A beatiful mind" with them - that will put.them off!

    My best advice is to eat well, exercise, sleep (as you discussed) and try to get to the root of your depressions. It's all reactive in the main.

    Come.back to the UK and ignore the swiss obsession with ECT... It's like a national institution there! Or at least demand credible answers when it comes up in discussion again.

    big huggles from Lexi and Clarissa to you and Sam kitten,

    X C

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