Apathy

At this stage I'm experiencing a greater problem: that of near complete apathy. I can't feel anything but numbness and sadness 24/7. I care less and less about everything. I'm outside looking in. It's so disturbing.

The Lithium was a big disappointment. I was prescribed the highest dose that didn't cross the toxicity threshold. It did no good, in fact, it caused a noticeable increase in fatigue which was something I had no shortage of to begin with. The decision to discontinue was a let down because I liked the idea of taking something that was a naturally occurring element in the body and initially didn't have any adverse side effects or withdrawals. Even though it required regular blood draws for monitoring, I could deal with it.

Next I was given something called Fetzima. Never heard of it. Didn't really matter. She gave me another brown paper bag with a month's worth of samples as she commented that I would be her guinea pig with this one because she'd never given it to anyone before. After a month, it did nothing. No effect whatsoever. In fact it affected my urinary system with prostate-like problem symptoms. Those symptoms stopped immediately when it was discontinued. The doctor was perplexed but seeing as she's given it to very few patients she didn't have a whole lot of experience to comment on it. She brought up ECT again as an option but I just shook my head. I simply can't deal with taking that on. I fear irreversible damage. At least with a pill, I can stop.

Next up, Aplenzin. It sounded so familiar to me but I couldn't remember if I'd tried it or not. I told her it's possible I already took it. She said regardless, she'd like me to take it WITH the Lexapro that's been a constant for quite a while. After checking my list, sure enough, it was there. Seems new ideas are in short supply. I'll jump through this hoop and see what happens. This is what it's been, this is what it might always be.

In Sickness and in Health

The Brintellix was miserable. Either the side effects of it or the withdrawal from the Lexapro or a combination of both caused sleeplessness, hightened anxiety and shortness of breath so I immediately abandoned it and went back to the Lexapro. I used to be able to power through the side effects of a new drug but I'm weaker now and can't weather it as easily. My "pdoc" suggested Lithium. I tried it several years ago prescribed from a different doctor. That doctor paired it with another drug called Lamictal. Lamictal can cause a side effect of a skin rash that can become quite dangerous if not caught in time. As luck would have it, I noticed early signs of some kind of skin change on the sides of my torso. When I showed him he didn't want to take any chances so both the Lithium and Lamictal were stopped and we went on to something else. I never learned if Lithium may have been of any help. So now I've told my current doctor that I'm not opposed to trying it again by itself. I'm finding it so hard to care.

Things are progressively getting worse in ways that leave me feeling utterly powerless. This depression is like a slow, creeping fog that permeates every nook, cranny, crevice, gap and aspect of my life. I've written a couple of times in this blog that my situation has affected my marriage. It's becoming serious now as my wife is requesting counseling for us.

We recently went on a family vacation that I tried to enjoy as best I could but my inability to do so ultimately caused several instances of unrest and tension. What should have been a relaxing, memorable getaway degraded into frazzled nerves and resentment several times. Mostly my fault. I have a low irritability threshold that rears its ugly head at all the wrong times and wrong places. Vacations are very important to my wife. For this most recent one to be a bad memory has me feeling guilty and insensitive. Since returning back to our daily routine, we have not been getting along. I blame her, she blames me. Stalemate.

I spoke to my counselor about possibly seeing us both to discuss our marital problems but she wants to speak to my wife alone first. We saw a counselor a few years ago but he bluntly told us that I need to get myself together first before the marriage can be addressed. My wife did not like him. We saw him twice and that was that.

I'm the first to admit that I'm terrible with communication. I've not really had too many friends in my life. I have a younger brother who's the polar opposite of me. We had a falling out a hundred years ago that was completely my fault. We patched things up long ago but many years were lost. It was the biggest mistake of my life.

I struggle with the spoken word. I'm better with writing things down so I can give some thought to prevent foot in mouth syndrome which I experience often. Lack of communication has been the weakest link in the marriage. I'm self absorbed by self pity. My focus is strained. Concentration is lost. It compounds all the problems and bleeds over into the marriage. I don't know how the marriage can be repaired when I can barely keep myself afloat. I have to muster the energy to keep everything together but things couldn't be more daunting right now. One day at a time I suppose.

"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.