Open : Why Asking for Help Can Save Your Life (9781788402286) by Bridge Frankie; Maleha; Mcphillips Mike

Author:Bridge, Frankie; Maleha; Mcphillips, Mike
Language: eng
Format: epub
Publisher: Hachette Book Group USA
Published: 2020-11-25T00:00:00+00:00

There is also a general sense that medication is like putting a sticking plaster over the problem, rather than really getting to grips with it, that doctors are trigger-happy when it comes to prescribing and that therapy will provide lasting benefits that will keep a person well in the future, whereas medication will stop working as soon as the patient stops taking it.

Often, these things are true: therapy is the best approach and it really does provide benefits for the future once it ends.

However, this is most true of a comparatively mild depression with an easily identifiable trigger and a recent onset. Sadly, Frankie’s illness is not mild and she came to therapy in a very deteriorated state, with her worst-ever symptoms. There are several factors in her illness that strongly suggest she should be on very long-term medication:

• First, she was young when her illness first began and has a family history of depression, both of which suggest a strong genetic influence

• Second, there was no clear and obvious trigger for her episodes

• Third, she has shown little tendency in the past to go into spontaneous remission, her illness simply grumbles away for year after year

• Fourth, though she has found therapy very helpful, it has never been enough on its own to keep her well

• Fifth, her illness is both disabling and dangerous; it has the capacity to stop her in her tracks and put her in a psychiatric hospital for months at a time

For Frankie, long-term preventive medication is presently a reality that she has come to accept as the price of living a full and normal life uninterrupted by breakdowns.

My own journey with medication has been long and frustrating. And it’s still ongoing. Mike has reached the conclusion that I have Treatment Resistant Depression. That means I seem to respond well at first, then slowly the medication becomes less and less effective, even though I always end up taking the maximum dosage possible – often the same amount recommended for a large man (sometimes twice the size of me!).

The side effects are often the problem too. Typically, the medicine results in headaches, nausea, tiredness, low – or no – libido, a horrendously dry mouth, weight gain, constipation and, most embarrassing of all, involuntary muscle spasms (although, in truth, none of them are great!).

Depression is usually defined as being resistant to treatment if it has failed to respond to two different antidepressants given for an adequate time period (usually at least 6–8 weeks) and at adequate doses (at, or near the top of, the recommended dose range for each drug), with good compliance (meaning that the patient has been consistently taking the medication) and with no other obvious complicating factor (such as heavy drinking or drug use). Treatment Resistant Depression affects up to 30 per cent of my longer-term patients.

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