No Cure

There is something about depression that the doctors and Mayo Clinic websites don't tell you. There is no cure. They cheerfully tell you that if you are in some kind of extreme situation, that you must "contact a health care professional". It sounds very comforting, but it is, unfortunately, rubbish. Health care professionals are utterly at sea with most of this stuff, where they are not outright incompetent.

My own past experience with doctors in North America has taught me to stay far away from them, even in situations that others might regard as emergencies.

Depression is usually called the "common cold" of mental illnesses, but it is also one that remains stubbornly difficult even to treat effectively. In our awful world, nearly everyone is at least moderately dysthymic and most people will experience the symptoms of a major depression at least once in their lives. And yet...

Despite what is said about the "new" anti-depressants, they are not miraculous. Often they don't work at all, and in some case, actually make the symptoms much worse.

This last happened to me. Ten years ago, I was treated in the now-usual way for depression by being loaded up with drugs. Nothing was offered in the way of talk-therapy (for which I am now grateful). I was given the standard SSRI drugs, plus helps for sleeplessness. I got worse. They increased the dosage. I got much worse.

This continued until I was a walking experiment. I ended up on five or six different anti-depressant and anti-anxiety medications and I was a basket case. I slept two or three hours every other night. I walked compulsively and was unable to stop moving. One day I walked for 18 straight hours, sitting on park benches and garden walls for only a few minutes at a time. I lost 40 pounds and could only eat tiny amounts of fruit. My short term memory was shot (Ativan) and I often could not remember if I had spoken with or seen someone only a few minutes after leaving them. I repeated myself in conversations with people, being unable to remember what I had said or where the thread of conversations were going.

In my brief visits with the doctor, sometimes with six weeks or more between appointments, he would ask me how I was feeling. I would tell him and then he would prescribe me either a new drug to be added to the rest or an increase in the existing ones.

At one point I protested, saying that I was not soup, that you couldn't just keep throwing different things into me to see how it would work out. There had to be some kind of plan. He responded by getting personally offended. "Don't you trust me to prescribe the right medications?" This after nearly a year of steady deterioration and incapacitation.

Finally, I was told during one of my many short visits "inside" that if I didn't improve, I would probably die. They started to use the term "non-compliant," which technically meant that I was not responding to any treatment, but was used as if I were somehow doing it on purpose.

Finally, something in me woke up and said 'enough'. I had been told by a friend about a pschyopharmacologist who had helped. I had to insist on a referral to this guy (under Canadian health care rules, you can't just call a specialist, you have to be referred by your attending physician. If the physician doesn't approve the idea, or if he is offended at your lack of trust, he won't refer, and you don't get a second opinion.) But I managed to convince my GP to send me to him.

In a five minute interview, he asked me questions about my medical history (no one else had ever done this) and discovered that I had been diagnosed in childhood with temporal lobe epilepsy, which exacerbates the symptoms of depression. I had never recieved treatment for my epilepsy which, in 1979, they told me would "naturally burn itself out" when adolescence hit. And it is true that after age 16 or so, I only had seizures extremely rarely, and then only under heavy stress or when I was having a high fever. I had even stopped thinking of myself as someone with epilepsy.

Well, since 1979 they have discovered a few things about epilepsy, one of which is that it does not go away, though the symptoms may change over time. This specialist reacted with shock when I told him how many and what kinds of different psychotropic medications I was on. He said I should not be taking any of them because with epilepsy, the effects of SSRI medication was effectively reversed. The more they gave me, the worse I would get. He said that they had 'lowered the threshold of seizures' in my brain and that the more I took, the more seizures I would have. This explained the weird symptoms I was having (the compulsive walking, the hallucinations and delusions...yes, it was just great!).

He gave me a strict schedule to ease myself off most of the drugs, keeping only the little oblong blue thing that was the only thing that would allow me to sleep (since forgotten its name, darn it!). I was to spend a lot of time sleeping and resting and not taking medication. Then when I was off most of it, he gave me a prescription for a mild anti-epileptic drug which I took for a year.

And it was only then that I had that experience they say you are supposed to get with the SSRI's. The sun did, finally, come out from behind the clouds. Slowly I got back to eating and sleeping normally and put on weight (a little too much!). I enrolled in a course in university and did well.

All this took a year. And I had been ill for a year. That was two years this fiasco took out of my life and if it had been the US instead of Canada, I would be suing the pants off everyone who had a hand in it.

So, now that I am no longer in North America, no longer in a country where medical care is easy to get, and facing another depressive state, what now?

Don't know, frankly. Am just gritting teeth right now and trying to keep my head above water. But even if I could see a doctor, who spoke English and was not trained in a third or second-world hell hole, I think I would give it a pass.

So the blog is a way of keeping track of what is happening. I am going to try to be as objective as possible. My model is CS Lewis who wrote a harrowing little book in which he criticially examined his reaction to the death of his beloved wife.

The idea of criticially examining my reactions, symptoms and thoughts as I go through a mind-altering experience, reminds me of that old Far Side cartoon in which a clown sits in a laboratory writing in a notebook: "Day fifteen. I can no longer resist the urge to throw a pie into the faces of my colleagues". Like one of those scientists in the movies who injects himself with the serum and then keeps a note book of what happens to him, until he turns into the monster and eats everyone.

According to the standard tests, I'm registering as somewhere between medium to severely depressed. I experience all the normal symptoms with a few extras I will probably write about.

We'll just see what happens, shall we?