Posted by viridis on September 22, 2002, at 4:06:10
In reply to Re: Unresponsive to SSRIs? What worked?, posted by Silly Brain on September 22, 2002, at 1:37:58
Hi Silly B,
Your attitude is a lot like mine was for years. It's amazing how inept some doctors can be. I could tell you so many stories ... like the doctor who told me that modern antidepressants either work or have no effect at all, period. He prescribed Wellbutrin, starting at triple the normal, beginning therapeutic dose. When I questioned this (since I'd researched it a bit beforehand), he said don't worry, it would be fine. Luckily, the pharmacist didn't think so, and checked with the doctor, who then said he'd accidentally written the wrong dosage on the prescription. When I reported ongoing, serious side effects with it (at a standard dose for 2 months), the doctor said this wasn't possible, and that I must be imagining them (I'm not sure how I could "imagine" physical and mental feelings I've never had before). SSRIs were awful for me, but various doctors just kept pushing them anyway, until I finally just refused SSRI treatment.
I could go on, but you get the point -- there are a lot of incompetent doctors out there. I got lucky with my current pdoc (who, by the way, said Wellbutrin would be just about the last thing he'd prescribe, given my situation). But it wasn't really just luck -- it was also perseverance, after a string of inappropriate treatments and misguided doctors.
It hardly sounds like you've exhausted the possibilities (although I'm sure you're exhausted!). Maybe you can get through this without medication, but I doubt it -- at least, not in the sense of achieving lasting relief. If you've had long-term, serious depression, then the chances are it will continue and/or recur without drug treatment. And, the chances are that there will be treatments out there (not necessarily SSRI) that really work.
All I can say is, keep seeing different doctors (ideally psychiatrists or psychopharmacologists), and go in armed with knowledge of the available medications, their properties, and what you suspect might be appropriate for you. Try not to act too pushy or seem like a know-it-all, but be firm and show that you have some idea of how these things work. Be open to their suggestions, but if you encounter a doctor who dismisses your ideas, insists that only one specific drug will work, or ignores a negative reaction to a particular treatment, then move on.
This takes a lot of energy (very hard when you're depressed), but it sounds like you have many things on your side. You work in a medical setting, so you have access to information and probably have a better understanding of medicine than the average person. You won't put up with nonsense from inept doctors, and you sound like you're better equipped than most to spot the bad ones and not waste too much time with them. And, you've obviously got drive that's just being drained by this illness. Why else would you be posting here and looking for help?
I wouldn't give up on pharmaceuticals yet if I were you, although I totally understand your frustration. Find a good doctor, and the chances are excellent that you'll get well. It may take some time, but what do you gain by giving up on treatment at this stage?