I saw the pdoc yesterday. He brought up ECT. This morning I thought fine, let’s do this. I’m sick of feeling the way I do. I don’t want to try yet another med that I’ve already tried only for it to work for a month or so and then stop working. But I’ve been through the list of SSRIs and everything else but the tricyclics and oral MAOIs.
When I went to the bathroom this morning it was with every intention of getting in the shower afterwards but when it came time, I just couldn’t. I’m not even sure I didn’t have the energy so much as I just didn’t have the will. The motivation. And motivation is a HUGE red flag, which is why I was all about ECT this morning.
Brian took me to see my therapist this afternoon, and I changed my mind about the ECT, at least for now. We worked out that the kernel of my day-to-day depression right now and for a while, has been the IBS. So the plan is to see my family doctor and find out if I need to see a gastroenterologist or another colorectal surgeon. My current IBS doc is a CRS in the suburbs. He isn’t in the far suburbs, but I want someone closer to home.
Meanwhile, after the pdoc mentioned ECT yesterday and went through my chart and realized I’d been on all these different types of antidepressants, he suggested EMSAM, which is a patch. I reminded him that I’d tried that already, but I couldn’t remember why it didn’t work. I was ambivalent about it, so he wrote a separate prescription for it (he writes the Rx for all 3 of my meds on 1 sheet of his Rx pad). Like the Abilify, which I was on when it first came out, I was put on EMSAM when it first came out, so like the Abilify last spring, I will probably try EMSAM again.
Although EMSAM is an MAOI, it doesn’t have the dietary restrictions (no chocolate, cheese, wine unless you want to die, for real) that traditional MAOIs do, although according to their medication guide, at a 9mg patch, you can’t eat those foods. I’m starting on 6mg. There’s also a contraindication with using Tegretol, but Tegretol is also contraindicated for birth control pills and that’s never been a problem. So I’m waiting to hear back from him about whether or not I should use it because I will not take any other mood stabilizer other than Tegretol.
Aside from that, there’s the whole logistics of the thing. He said to put it on early in the morning so I’d be able to sleep at night, but wasn’t sure if it’s OK to take it off like, while working out or showering. There was nothing on the web site mentioning it, either. So I’m having obsessive thoughts/anxiety about how to use it: is it OK to take it off for a little while? What if I take it off for more than 2 hours? What if it doesn’t stick back on? Etc.
On the other hand, though I’m using everything in my willpower that I have to write this post, I honestly don’t know if I’ll have it to drive myself to my fitness class tomorrow. Perhaps I need to readjust my goals as far as that goes.
that is one bad thing about antidepressants, they stop working then they up the dosage and add more meds… it’s a nasty little cycle.
the fact that you did this post says something! it tells me that you DO have motivation and interest. no matter how little motivation and interest you have, at least you have some.
Yeah, that’s why I asked to stop taking them altogether last spring. I didn’t stop on my own, of course, and my pdoc agreed to try it. I felt immediately better. Last summer was the best I’d done in years, as far as getting out of my apartment and driving places.
Honestly, I have my friend/upstairs neighbor to thank for that. But she’s a single mom and full-time student, and when school started, I didn’t have anyone who could just come down here to kick me in the ass and be like, “Come on! We’re going out for coffee!” I was able to do it on my own up until our trip to Iowa in November.
And you’re right — I did post something. You know how I’ve disappeared from my blog for months when I’m uber-depressed. I’m trying not to do that this time.
Okay firstly, I TOTALLY GET the no shower thing. Showering is my biggest downfall. It is the start to my non-functioning phase and when I finally do shower, it can even be the end to that phase. But showering in my life is super powerful and it takes me a huge amount of willpower to do it, every single time. You wouldn’t think it would have to be so much work. Normal people just do it. Why does it have to be so hard for us??
Secondly, ECT, yeah. It could potentially be helpful for you. There are major benefits and some possible drawbacks. But everyone will tell you different stories. It’s different for everyone. I haven’t tried it but I know a million people who have.
MAOI’s.. No chocolate? Ahh, that would be hard. But sometimes, if it’s the ticket to a decent life, then maybe it’s worth it. And hey maybe it might help with a little bit of weight loss too, curbing some of those foods out of the diet. You never know!
I’m sorry you are in the midst of such a depressed phase. Hang in there. Go easy on yourself, ok? Take care.
Hi, Jane and welcome to my little corner of the blogosphere. My therapist has told me that not everyone, even abled people, shower every day but for me it’s a red flag. Brian thinks it’s because I have this intricate routine but that’s not true. Well, maybe, but I’ve timed myself and I can be completely showered and dressed in under 40 minutes.
And that includes using the bathroom, if you know what I mean.
It’s just that when I start that downward slide, dragging myself into the tub becomes more and more of an effort, especially when I’m PMSing. On those days, I can remind myself of that and it becomes easier. Right now it’s a different story.
I’ve actually had ECT. A lot. My big fear is anesthesia, but I’m quirky about that. Anyway, it worked tremendously until I had situational stuff that triggered severe depressive episodes again. And again. The reason I’m hesitant about doing it now is because I don’t want to be hospitalized, which they do for observation for the first set of 6 — to make sure you’re OK medically. If you have maintenance ECT (1 session every 4 – 6 weeks), that can be done outpatient. The other reason is that my short-term memory is finally improving.
Chocolate — I probably could live without it, especially because of its effects on my IBS; what I’m paranoid about is accidentally eating some dish that has cheese or wine in it. What a way to go like, how much would that suck?
Thanks for writing.
It is frustrating when you have come to a point where you only have very little option of choosing your treatment. I am at the stage where my doctor recommends the ECT treatments because I have been through every medication.
You are at least doing something, which is better than nothing. When you are that depressed, and you still find the kernel of energy to talk about it on your blog you are helping yourself.
I wish you the best of luck with the patch. It sounds as bad as the Clorazil the doctor wants me to try. I understand your obsessive thinking about it. Sometimes it is so dang scary taking all these medications we really know nothing about.
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I just wish I could remember if the last time I was on that patch if I was taking Tegretol. Brian insists that I was, but I could’ve been on Depakote or Lamictal, I really don’t know. Part of me would still rather have the ECT because the effects are instantaneous — no waiting for weeks to see if it works. And no obsessive thoughts about using the patch or worrying about what I eat! Anyway, still waiting to hear from the pdoc about the EMSAM and if it’s OK to use with Tegretol. One of the office managers even left a message with his wife so you’d think he’d call back by now! Or maybe that was a bad idea. LOL
Anyway, I have more energy today than yesterday, so that’s something.
Sorry to hear about all this. I understand not wanting to go the MAOI route if possible, but why not tricyclics? Also, if you haven’t already tried done so, consider seeing someone about balancing out your hormones. -You know… just for kicks
For some people, that does wonders for the “out of nowhere” changes. Might not cure everything, but heck, if it even just takes the edge off at times, it’s worth it.
Hope things even out to a more tolerable level for you soon.
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You know, my pdoc and I had discussed tricyclics years ago, but I can’t remember why the vote was no. Probably the side effects; they include constipation (which I certainly don’t need because of my IBS) and weight gain. I refuse to take anything that will cause me to gain weight because no matter how much better the medication might make you feel, you can work out and diet as much as you wnat but that weight will not go away until you stop taking it. I had an extremely bad experience with Lamictal and do not want to repeat it.
Those are good reasons. Those are both potential side effects. Of course there’s always the chance you might not get those side effects, but they’d be a real PITA (no pun intended! Lol!) if you did!
Oh, and the hormone thing — I forgot to tell you. When I was diagnosed with a uterine fibroid a couple years ago, which has, unfortunately, increased my PMS symptoms including depression, I went through so many different oral contraceptives. Ugh. We finally found one that eases the emotional symptoms (depression, irritability) somewhat, but at least makes my periods regular. Sorry if that’s TMI.
Not TMI
-This is, of course, JUST a suggestion, because what the heck do I know about all of your specifics… but look into natural progesterone therapy too. I’m sure you can find out tons about it on the web. It helps a lot of people -and of course does nothing or does screwy things for others 
Dontcha hate that? 
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That’s exactly why I’m reluctant to try new therapies — because I don’t want to see what, if anything, happens even if it’s good. I’m just so tired of taking so many meds. I take about 9 or 10 separate tablets/caplets at night and can gulp all of them with one swallow of water. Kinda sad. Or scary.