15 December 2009
While chatting with Stella today, the subject of meds came up. She dismissed my concern about receptor sites and neurotransmitters. Stella's mood is always deeply depressed, she is often uncommunicative, often decompensating. Her physical movements are exasperatingly slow, as if she has been drugged. She is quite the opposite. She has declined to take any medication for years. Stella maintains that "antidepressants don't do a damn thing." She has case management and sees a psychiatrist occasionally. Since she has been unable to keep appointments, her mental health provider agency has placed her on the clinic schedule. Clinic means that her appointment is not with a specific psychiatrist, but rather with whichever psychiatrist is up next to see a patient. It's like a cattle-call audition for movie extras: Stella shows up (usually) at 10 a.m. In the waiting room are fifteen or twenty other agency clients who also have a 10 a.m. appointment. There are two or three psychiatrists in the exam rooms who gradually work their way through the crowd of patients. If Stella happens to be one of the last patients seen, then her wait can be as long as two and a half hours. I tell Stella that it frustrates me, her lack of interest in meds, or in therapy, or in trying to manage her depression. I tell her that if she's not careful, her disorder could become integrated into her personality. Instead of having a disorder, she could literally be the disorder. She scoffs at me. "Hell, that happened years ago. Or so the goddam doctors say." I've taken Effexor since 2000. Added Welbutrin to that in '06. I suspect that many people say "antidepressants don't work," when what they really mean is, "antidepressants don't make me happy." To me, it's like saying, "This damned insulin won't grow new beta cells in the Islets of Langherans in my pancreas!" I don't think any class of antidepressant will bring happiness. At best, it allows us to function, to sleep better but not perfectly, to process information better, but not on a genius level. I try to manage my disorder. I have no illusions about curing it anytime soon.
Posted by David Carney at 17:43