As it turns out, I don’t respond to psychiatric medication.
I’ve tried dozens of mood-lifting pills in the past decade, and none of them has consistently worked. Those that do create any beneficial effect usually only do so mildly, and they wear off in a matter of weeks, leaving me just as despondent as I was before.
I have a biological resistance to meds. I know that because a) I’ve been trying them for ten years, which is long enough to know that they don’t work, b) I’ve tried many different types of meds, c) I’ve been on therapeutic doses of all of those meds, and d) I was given prescriptions for them from certified psychiatrists who expected to see them work more effectively than they did.
Had any of those criteria not been met, I wouldn’t claim to be medication-resistant, because there would be a chance that I didn’t try every possible opportunity to respond well to medication. As it is, however, I’ve exhausted every option and tried every avenue of finding meds that work on my depression, and I’ve still come up with nothing.
If you find yourself relating to my story of taking therapeutic doses of many different prescription pills for several years and still seeing next to no improvement, you may have an uncontrollable, biological resistance to psychiatric medication.
And, while that sounds scary, it’s okay.
You’re not out of options just because Paxil doesn’t lift your mood. While inconvenient, there are work-arounds to psychiatric medication resistance. One for which I can personally vouch is electroconvulsive therapy (ECT), which is an extremely effective antidepressant treatment that I have been receiving for the past several months, and which I explain in more detail here. Essentially, during ECT, the depressed patient is anesthetized and an electric current is non-invasively sent through their head, causing a short, controlled seizure. The body’s response to the seizure causes a biological lift in mood. This procedure is repeated periodically over the course of several months.
The problem with ECT, however, is that its side effects force patients to give up things they can’t always afford to lose, like the ability to drive, navigate, or retain certain memories while the procedures continue. And while it’s an outpatient process, it does take several hours to recover from general anesthetic, which means sacrificing one or more whole days a week for several months. While I’ll firmly argue that it’s worth not being able to drive for a few months in order to become mentally healthy, I understand that some people need to drive for job- and career-related reasons that they can’t always easily forfeit.
There are options besides ECT, however, which don’t involve as much anesthesia. Repeated transcranial magnetic stimulation (rTMS) is an increasingly popular treatment for unipolar (as opposed to bipolar) depression. During rTMS, a magnetic coil is pointed at the patient’s head at a particular angle. The current it generates interacts with the patient’s brain in such a way that depressive symptoms clear up. While the procedure does have to be performed repeatedly and can cause side effects like headaches, it’s a relatively simple treatment, especially given the wonderful effect it can have on a person’s mood.
Not every mood treatment is noninvasive, however. In more severe cases, vagus nerve stimulation (VNS) is an option for lifting depression. In VNS, a device called a pulse generator is implanted in the patient’s chest, where it’s used to stimulate the left vagus nerve. The vagus nerve painlessly communicates signals from the pulse generator to the brain for ten years, at which time the generator’s battery is replaced and it operates for another decade.
VNS is a surgical process, but on the upside, it operates automatically for years at a time, and the implantation process doesn’t need to be repeated as often as ECT and rTMS do. And the signal transmission process that takes place between the pulse generator and the vagal nerve is painless, which is another benefit of VNS.
I am, fortunately, a statistically unusual case when it comes to psychotropic medication resistance. I say that’s fortunate because it means that psych meds work on most people who need them. The average person with a psychiatric disorder – let’s use depression as an example, since it’s so ubiquitous – finds themselves feeling better after just a few weeks of taking an antidepressant or two. Maybe they don’t feel perfectly back to normal because of one pill, but at the very least, they’re likely to feel better. For the sake of improving the lives of most mentally ill people, I am a firm believer in psych meds – just not in my case.