Posted by Adam on November 16, 2000, at 20:51:57
Hi, folks,
It's been quite a while since I posted here, so some of you may not know me.
A little less than two years ago, after a 10+ year battle with depression, it got so bad I wound up hospitalized, and received electroconvulsive therapy during my stay. This was rock bottom for me, and I can hardly describe how truly awful it was. I had, prior to that, tried about every class of antidepressant available, some in combination, except an MAOI. Roughly six months after that I enrolled in a research study (one of many of its kind) at McLean Hospital, near Boston, MA, where they were testing the efficacy of the Selegiline Transdermal System (STS) for major depressive disorder.
After completing the double-blind, placebo-controlled portion of the study, I was then allowed to use the active STS, at a dose of 20mg/day, for six months. I responded almost immediately, and, in quantitative terms, experienced a change in Hamilton Depression Scale score of about twenty points over the course of a month. In qualitative terms, it was indescribable. After the study ended, I switched to oral selegiline, and have maintained the therapeutic benefit on a relatively low dose (15mg b.i.d.).
I am quite literally moved to tears at times by things I had written in journals or scraps of poetry before I was sucessfully treated, not so much because these musings were in any way brilliant, but because they were so thoroughly bleak, hopeless, and tortured. I'm not sure I could have lasted another year, much less another ten. I'm fairly certain I would have taken my own life, despite my own personal objections to such a choice, eventually. A halfhearted and aborted attempt had already opened the door to that corridor, so to speak, and it began to seem like a sensible lesser of two evils.
I can’t say, in retrospect, whether or not I was deserving of such a change, if it was my time to experience something new, if my mind tricked me into thinking I was healed, if my biochemistry was out of whack before...I simply don't know, and probably never will.
What I do know, quite certainly, whatever I believe to be the mechanism that helped me, is that I am greatly relieved of depression, and it appears that I might stay that way. I knock heavily on whatever chunk of wood I can find whenever I think such a thing, that this could be (dare I say it?) permanent. I do certainly hope so. I nearly catch myself praying so, despite a powerfully secular humanist mindset, largely because the past is so terrifying, the present almost ineffably better, and the change like a bolt from the blue.
All I can say is that it can happen, and I do so very much hope it may happen to you someday if you are still suffering from depression. I beleive the odds may be in your favor if you keep working at it. It was very hard for me. I wound up at so many dead ends, and in such dire trouble at times. I hope you believe me when I say all of this is true, what happened to me, and what could happen to you. It might not be so quick or stark, but it does happen to people. They do get better, and it can last. My girlfriend is a bit like me in that regard, and we both share a certain amazement at the contrast between past and present. We both are coming to terms with the idea that we may very well have to stay medicated for the rest of our lives to maintain this quality of life, and that we are essentially the victims of a chronic illness that will never be completely cured, just controlled. So we have to be careful.
I'm far from perfect. I'm still a bit impulsive. I'm not so organized as I'd like to be. I'm a bit obsessive (in the clinical sense), and that can be a challenge. The drug can still make me a bit jittery at times, it causes insomnia, and I have to watch my diet and what medications I take beause of the potential for life-threatening interactions. I sometimes get a bit hypomanic, which is actually kind of fun, but I’m given to "odd" behavior at such times, mostly in the form of late-night writing sprees like this one, and a rather uncharacteristic effusiveness. I usually keep it under control, though :-).
Since I'm not sure if "the patch" as the STS was often referred to, will be approved, it may mean these problems/quirks will be with me for the duration. They are, fortunately, relatively inoccuous, and a more-than-equitable trade for relief.
I hope you hang in there, and that some day you can experience some joy. Again, I really believe that you can, as small a consolation as that seems right now. I can't fool you, or talk down to you. You and I both know how badly it hurts, and how impossible any real improvement seems. Nonetheless, I do not think I was merely lucky. A brief reflection on my life does not bring to mind words like "lucky". Just better now than before, after a very long fight. Keep fighting. All the best to all of you.
Adam
poster:Adam
thread:48935
URL: http://www.dr-bob.org/babble/20001115/msgs/48935.html