Advice From A Psychiatrist

The further we go and older we grow
The more we know the less we show
-- The Cure

I have averaged four psychiatrists per decade. Most of them I had to change due to moving out of the area but two of them I changed because they seemed to offer very little face time before tweaking medications. So I suppose I was a good advocate for myself since I know I need more than a doctor who tries to rush me out of the office.

The quasi-defined term "treatment-resistant" is an understatement for my depression and twice I have been treated by multiple psychiatrists. The first period was when my long-term psychiatrist was handling most of my care/medications while a temporary psychiatrist treated me with electroconvulsive therapy. The second period was similar but the temporary psychiatrists were treating me with ketamine infusions.

Now for me, and I imagine most people with various levels/types of depression, when the depression really takes hold, it is a struggle to do simple tasks like go to work, wash clothes, or even pick up the phone. So I had hoped in this era of technological marvels that when I am at my worst, at least I am paying a doctor's office and a larger healthcare system to keep track of my medication details including their efficacy for me. There is much said about how our "medical records" have oodles of laws protecting them from prying eyes so I always assumed that my records were not only protected but of a quality that was worth protecting.

That was a poor assumption. My records from one doctor are not very helpful to the next doctor, or they are incomplete, or various parts are archived in various locations each with different access protocols, or in formats that I am unable to decipher, or all of the above. So next time you visit a new doctor and you have that form to sign that grants the new doctor access to records from other doctors, sure that covers the new doctor's office from a legal standpoint but it is no guarantee that the office is going to get relevant records that will help your treatment.

So my psychiatrist's advice? Keep track of all your medications and how you responded to them. Yeah, let me do that for the scores of meds I have been on, never mind the hundreds of combinations noting how the varying dosages slightly improved symptoms or not, all the while filtering out the impact of other health/life challenges and taking into account how some drugs can take weeks before having an effect, and never being fooled by the placebo effect. When I can barely get out of bed.