"I've Not Seen This"


As promised, I made good on a follow-up visit to my psychiatrist post Ketamine infusion for the first time in two years. She had moved her practice to a new building and had a new staff. Not the friendliest bunch but I've found that to be the norm with these doctors.

I reported to her that the Ketamine was very disappointing. She hadn't worked with it at all so couldn't really comment on it too much. I'm the only patient she had that's tried it. I then bluntly asked her if it's possible I'm really not clinically depressed because of a chemical imbalance since no chemicals have yet to correct the situation. Is this just how I am? She replied absolutely not. This isn't normal and it can't be traced to a character flaw. There has to be a medication that will help. The obvious reply from me was.....(sigh).....what's new out there that may hold promise? She listed a couple drugs I'd never heard of. I told her what I was currently taking (Lexapro) and the dosage. She asked if it was helping and I said it has a numbing effect at best but doesn't really lift the depression to any degree. She then asked why I was taking it if it really wasn't helping. I reiterated how the numbing properties took a slight edge off the depression and anxiety and Lexapro has the least amount of side effects for me. I basically just settled on it as the best of the worst.

She asked if I'd had any recent blood work done. I had had a physical a couple years previous and the blood work was normal. Several years before I went to my regular doctor to have specific blood work done to possibly pinpoint a medical problem causing the depression like thyroid or hormone levels that might be off kilter but everything was fine. Regardless, she wanted to see blood work so wrote up a referral to a lab.

I brought up the issue of having shortness of breath which I've been experiencing for about 3-4 years now. I thought it was related to my sleep apnea but several doctors said no, that's not how the body works. I'm physically very healthy so I can't imagine that it's a medical issue so I dismissed it as a symptom of anxiety. She asked how often I experience it. I told her it's constant. She said that can't be from anxiety. It wouldn't be constant. Shortness of breath from anxiety is intermittent, not constant. She highly recommended I get it checked by my doctor.

Next, she said I should try something called Brintellix. I don't really know what it is but it works on things in the brain that Lexapro doesn't. Side effects are minimal.

I really didn't care. I just agreed to try it.

She had free samples and a brochure. Like all other drugs, Brintellix had a slick campaign complete with a fancy logo, tagline and eye catching graphics. The plan was to wean off the Lexapro and start the new drug. I asked if this one doesn't work, then what....knowing exactly what her answer would be. On to the next one.

At one point during the conversation she said, "I've not seen this" referring to my treatment resistance. Again she repeated, "I've not seen this." She had said something similar a few years earlier that I documented in this blog. I was hands down her most challenging case but I didn't detect that she was eager to meet the challenge. Though I like her, she exudes a quasi-exasperation with me. She's stumped and not proud of it. Neither am I to say the least.

I took the little brown bag with the samples and left the office feeling worse than when I had arrived. Deflated. Defeated. Numb. Exhausted. Indifferent.

More pills.

The next day I went online to research the drug a bit. I found a testimonial page that I skimmed over. Many raved about this medication, others panned it. I no longer hold stock in anyone's opinion any more. Only I can find out for myself because everyone's different. I admittedly have a terrible attitude towards these meds. I "know" this one will fail like the others. I realize I sabotage myself with that thinking but that's my harsh reality. I could try to view it positively but I really don't have the ability to candy coat it. This drug will either work or it won't and then on to the next one.