That's exactly what my hope did.
*poof*
Gone. Lost somewhere in the stratosphere, floating around, uncatchable.
Or it's in the trash. I'm not sure at this point. (Floating around in the stratosphere sounds sexier though).
Why did my hope go *poof*? Well, I saw my psychiatrist, Mary, on Wednesday. And . . .
Wait. Let's back up a minute.
I want to recap what's been going on, in case you haven't read any previous posts. I'm depressed again. It's bad again. I have suicidal ideation on most days. I want to cut and I have. I alternate between wanting to die or wanting to not exist. It feels as though everything is being ripped from me again - I was starting to get stable over the summer and now everything is crashing down around me, hundreds of thousands of tiny shards and there's no way I can possibly pick them all up again. And every time I shatter like this, I miss a few pieces. Or a hundred pieces. Each time I break it's harder to collect those pieces, those shards, and this time they seem to be scattered further.
Okay. Back to Mary.
I sat in the waiting room doing a word search on my phone, feeling irritable and depressed. Surprisingly, I didn't have to wait long to be called back. Mary has a psychiatric nurse working with her who starts the intake - she gets my weight, blood pressure, and starts asking me questions. How are you doing? Bad. I'll go with that - the opposite of good. What's been going on? My depression is continuing to get worse. Five weeks ago Mary increased my seroquel and I haven't noticed any difference. I have suicidal thoughts more days than not. Do you have a plan? Yes. But I have no intent. Can you contract for safety? Sure. When was the last time you cut? This morning (I proceed to roll up my left sleeve). What's been going on the last few weeks? How's home? Work? Nothing has changed. Work is busy, home is fine. No triggers that neither I nor my therapist can identify. Any hallucinations? No.
She typed everything I was saying, went over my meds, and brought me back to Mary's office. I liked Mary when I saw her 5 weeks ago. I liked her more than Chika (she works with Mary and is who I've been seeing since June).
Mary is reading everything her nurse wrote about me. I sit down. She looks up at me over the rim of her glasses. Cami, right? Yes. Seems like you're not doing to well. Tell me about the suicidal thoughts. Um, well, I have ideation more days than not. I think mostly right now of slitting my wrists. Before it was always an overdose, but not now. I've had 3 days in the past 5 weeks that I probably should have gone to the hospital. But I'm stubborn and I didn't want to go - I wanted to try and manage it on my own. My therapist was a little mad at me because 1. I didn't go in, 2. I didn't call or email him (but he was in Italy on vacation and I didn't want to bother him), and 3. I didn't call you to let you know.
Before she asks another question I pull a piece of paper from my purse - the results of my genetic testing - and hand it to her. As far as my current meds go, my dosing is fine (the genetic testing was for medication metabolism - so, for example, if you're a high metabolizer for such and such a class, you'd need a lower dose of that drug).
Mary is looking at the results and to her computer screen. Results. Computer screen. Then she looks at me. You've been on a lot of meds. I know. She sighs. I don't think meds are going to help your depression. Look - you've been on so many and none of them has really helped, at least not more than a few weeks. Meds aren't going to help. I stare at her. The force of what she just said hits me hard and I'm speechless.
Wait. No.
Meds aren't going to work? You're telling me meds aren't going to work? (I think this, rather than say it).
She continues. Have you ever considered ECT? (I'm staring again). It can be very successful in treating depression. I haven't really thought about it for myself. Seriously, at least. It's just . . . the memory loss associated with it. Not such a good thing when you're a nurse. I'd have to be on leave for the entire duration of treatment (3-6 months). That's true. Have you heard about EMDR? Yes. You have a lot of trauma in your past, EMDR would be beneficial. I already do trauma work with my therapist. His specialty happens to be trauma. We're just moving at a snail's pace because it can be so triggering. My session last week was crisis intervention because of my depression. But we've been working on trauma. Okay, good. Have you heard of DBT? Dialectal behavioral therapy? There are group DBT sessions that you may want to look into. You learn coping skills and ways to manage your emotions. Okay . . . You could also look into neurofeedback. What's neurofeedback? You have electrodes placed on your head to measure your brain waves and then you learn how to change your brain wave pattern. Oh. Okay. Do you give me referral? How does that work?
I'm almost in a trance at this point. My head is reeling. I'm going into shutdown mode. Meds aren't going to help your depression. You don't understand Mary. I need meds to work for me. They have to work for me. I've been doing everything right. I'm trying my hardest. I'm fucking trying and I need a little help here!
She continues. You'll need to research groups nearby and contact your insurance company to see if they cover these treatments. Some companies do, most don't. You do need to work through your trauma. I think that will help. It complicates things. Okay. (I nod. I'm on the verge of tears. I'm trying desperately not to cry). She looks sternly at me. You know, sometimes people have this black cloud around them their whole lives and it never gets better. Maybe they have suicidal thoughts all the time and they're just there. It doesn't go away.
I'm staring again. I wouldn't doubt that my mouth dropped open a little bit. You're sitting here telling me that this won't get better. Meds won't work. Here are a few therapies you could try that may or may not help and that insurance probably won't cover but I'm trying to give you something to grasp for because let's face - nothing has worked before so probably nothing will work now, either. The same person telling me this told me 5 weeks ago that I didn't have to feel depressed - that we would find something that works and we can manage the depression better and don't give up because I'm hopeful that you'll get better soon.
This is not okay.
She must have read my face, my thoughts, my posture. Look, you should be proud of yourself! Look how far you've come! You're doing every possible thing you can do to get better. You're doing everything right. Okay. How about we try increasing the seroquel to 600mg? Maybe you just need more. Maybe your body needs a higher dose for the antidepressant effects. (I nod. I'm not hopeful. You told me meds won't work, yet we're going to increase a med that you don't think will work. Are you trying to placate me?) Okay. We'll try that for 4 weeks and I can even increase it to 800mg in 4 weeks if we want to try that. But we'll try 600mg for now. Look into DBT group and neurofeedback. And have a Merry Christmas! Okay.
I nod. I'm in disbelief. I make my way to the front desk and make my follow up appointment. The tears are threatening. I make it to my truck before I completely break down. I sat for 10-15 minutes sobbing. Uncontrollable sobbing full of pain and despair and frustration.
That was not what I was expecting from that appointment. Well, increasing the seroquel I expected. But not to be told that meds probably aren't going to work, aren't going to help, and we're kinda at the end of the line so maybe you should look into ECT because there really isn't much more out there for you. I was looking for hope, and I didn't get that. The thin strand of hope I'm desperately holding on to is unraveling.
And it fucking sucks.
I'm looking into DBT and neurofeedback. I'm going to discuss them with my therapist (I don't see a huge difference between DBT and what I've learned doing CBT with my therapist).
All I want is for something to work. I don't think that's too much to ask.
I've two docs tell me I need to sort through my trauma stuff and I have been. And even though I have been, I still can't identify triggers (I know some, and I can counter them so I don't have such a large emotional response, but I don't know most).
So I went up to 600mg of seroquel Wednesday night. Yesterday morning and this morning were hard to wake up to - for many weeks now I've been having a progressively harder time waking up simply because I don't want to be awake - but jumping from 400mg to 600mg seems to have made me more drowsy in the morning (hopefully that will go away).
The only thing I can do is to keep trying. At least my stubbornness comes in handy with this. My therapist had told me that as long as I'm breathing, there's hope.
I'd like to believe him.
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