Posted by yznhymer on October 22, 2004, at 10:55:03
In reply to Unlikelihood of remission, posted by Ilene on October 18, 2004, at 22:38:15
> The message I got from my pdocs today was not to expect too much from meds, because my depression is severe and chronic, and I've taken every type of AD on the market. I'm going to a mood disorder clinic at a major university teaching hospital. It's supposed to be one of the top ten hospitals for psychiatry in the country.
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> They encouraged me to seek psychotherapy, but weren't real optimistic about that, either. They seem to regard it as a way for me to survive within my limitations.
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> I can't decide whether to be appalled by their lack of sensitivity or thankful for their honesty. Thoughts?Looks like I'm in the minority here, but be thankful for their honesty. As a rule, honesty is the best policy and I don't see this falling into one of the exceptions.
First of all, we all kow the liklihood of remission is small even before they lay the news on us. My understanding is only about a third of patients achieve remission from meds, and another third receive only partial remission at best. A third get no relief at all. You've been through umpteen drug trials. The math is not hard.
Second, would you really be better off having your docs mislead you? Would your depression be any better? Shouldn't you know the liklihood of success before you take on the discomfort and potential health risks of another drug trial? Drug trials are not benign activities. You may decide to go through them anyway. I do, but I pick and choose a lot more carefully now than when I started this journey.
Third, your doc may be doing you a big economic favor. You don't want your doc mincing words when you're trying to access whatever benefits you may be entittled to. For example, I went out on disability retirement at virtually full pay three years ago due to my depression because my pdoc was willing to say (honestly)that my depression was likely to be permanent or last longer than a year. I can't tell you how huge that was in improving my life.
Fourth, improving the quality of your life within your limitations is not a bad thing. Meds, therapy, exercize, nutrition, supplements, alternative treatments, etc. individually may not provide remission but cumulatively may provide significant relief. Instead of pinning all your hopes on drug cocktails and feeling like a failure when they don't work for you, you've got some motivation to explore a much wider range of treatment options.
Fifth, in the final analysis, your doc's statement is just an opinion. You're free to accept or reject it, or find reason to believe you're going beat the odds, be the exception. People do that and I commend them for it.
I know what your doc told you is hard news to take, especially when one is feeling vulnerable to begin with. (Like you, I was somewhat shocked when my pdoc shared his opinion about the liklihood of remission with me and it took time to process.) Hopefully your pdoc delivered it with some compassion or at least professionalism like mine did. You're entitled to those. Your doc is not giving up on you, he's not refusing to work with you, he's not encouraging you to give up. He's just acknowledging a difficult truth: you (we) have a difficult row to hoe.
My point is that honesty and compassion are not mutually exclusive, nor are honesty and hope. Despite the fact that your doc thinks you're unlikley to achieve remission with currently available treatments, there is hope that research and new things in the pipeline may be the breakthrough you need.
Ultimately, we are responsible for generating our own hope. Pdocs don't cure us or even make us feel better. At best they can show us the way, provide us with tools.
I wish you the best...
M
poster:yznhymer
thread:404563
URL: http://www.dr-bob.org/babble/20041018/msgs/405854.html