I'm Caiphus and I'm awesome except for the mental illness part...

[Caiphus]

Hi.  I'm Caiphus and I was first diagnosed with depression when I was 15 - I'm 33 now and although there have been a few patches of relief over the years in between I have spent the majority of that time on one SSRI medication or another and unfortunately with very little benefit.

Despite struggling against a persistent depression for close to two decades I know there are a lot of positives about me and I can alleviate some of my symptoms occasionally by reminding myself (when it isn't so bad that I don't feel like I'm just delusional and lying to myself anyway.)

The one thing that is equally a gift and a burden is my high level intellect and self-awareness. It is good to be able to absorb, analyse and deconstruct large quantities of information. At the same time the biggest problem I have to solve is myself so I spend way to much time internally focused and putting all that computational power into an unsolvable problem.

In my late teens and early twenties I just wanted to party my way out of depression and that wasn't particularly successful. Like many of us I indulged in drugs and alcohol as a way to self medicate; was directionless and unstable and dropped out of uni twice.

The next eight or so years were about working out how I could stay middle-class without a professional education so I tried to make money by working in transient commission sales jobs. I did quite well during different periods, but over all it was really something that allowed me to be unstable and not get fired. When I did perform well I blew all the money very quickly, and when I wasn't performing well it was easy to put down to a lack of "motivation". Pro tip: don't put yourself in debt trying to motivate yourself to activity - it doesn't work and definitely doesn't make you feel better.

About five years ago I hit rock-bottom and I have steadily been building up from there.  I have been in a mostly happy and stable relationship, I went back to university and graduated with a Bachelor of Journalism (despite a few issues).

The last 18 months after graduating have been hard as I have not had much luck getting in to my chosen career. I've been finding it hard to project an air of confidence and struggling with anxiety to follow up networks.

I've just recently began ketamine treatment after a lot of positive media coverage. It's hard to say how well it works when coming off antidepressants at the same time.

Running out of characters, so ask me anything: I'm an open book.

[White_Rose]

Dear Caiphus

Welcome to Beyond Blue and to the input of the community members.

You have certainly had a varied career and I imagine you have learned and discovered a great deal in that time. What I cannot read in your story is how much professional help you have received.  You say you have been taking ADs for some considerable time, so presumably you have been in contact at least with your GP.  Has there been any other assistance such a psychologist or counselor?

The problem with trying to 'cure' yourself is not being able to look at yourself objectively. But I'm sure you already know that. Quite often we need the objective insight from others to help us on our journey. We also need that 'other' to have the requisite skills to help. Many of our friends and family members have what they think are the answers and are happy to pass them on. However, their ideas are not often viable or helpful. So this is why you need professional help.

I have no idea what ketamine is. What is it and what is it used for?  Is it a drug for horses? I would appreciate it if you could explain.

Just a quick reply.  Will write more when you reply.

Mary

[Caiphus]

Some of the things I didn't have space to mention in my first post:

Most of my mental health treatment has been through GPs and while they tried their best it was largely sub standard. At different stages I had referrals to psychiatrists but it has only been over the last 6 or so years (rock bottom rebound) I have been dealing with someone who I at least felt comfortable enough with to return on a regular basis.

When income and money management are an issue, it is extremely difficult to get decent help as most of us would know. High quality mental health practitioners generally demand a premium except for the few altruistic ones who bulk bill. The free market means the lower the gap the lower the standard of care in my opinion.

The only way I managed to survive at university and graduate was through the no-nonsense help of a counselor who had a specific focus on helping me get through. It would be great if the real world offered similar support.

It is easier now to get a basic level of professional support than it was when I was first told I was depressed and just sent away with an SSRI by a GP with no follow up.

Thanks for asking about ketamine. It's most commonly known as a horse tranquilizer or the party drug special K.

It's been used for a while now as an anesthetic in combination with ECT but there has been enough evidence to show that it is an effective treatment for depression on its own. Some of the media in hindsight has presented it in an irresponsible light as some sort of miracle cure. I took interest in it because it had been particularly effective in regards to anhedonia (lack of feelings of pleasure) from a lot of what I had read.  I hit up my psych about what he knew about it and I was fortunate enough that another psych he worked with at a different practice was running a clinic specialising in treating depression with ketamine, but it is run as a trial.

Ketamine is an old drug which no one particular drug company owns which means that it is incredibly difficult to profit out of and as such there hasn't been any real lobbying weight thrown behind it to get it approved for use as a treatment through the TGA, because there is no profit in it.

My personal experience so far is that it isn't a miracle, but I have felt a general lifting of mood. Whilst I have been emotionally dead for a while feelings are now starting to creep back in at the moment and they aren't all good.

I will be happy to report more on the treatment in the future.

[White_Rose]

Dear Caiphus

Thanks for your explanations. I did wonder about ketamine and its relationship to horses. So you have increased my knowledge today.

Yes, there can be a relationship between low fees and less experienced professional help. Not always the case though. But then you can pay high fees and get a psych who you do not get on with and the outcome is the same, not much. It good that you found someone you now feel comfortable with.

If you need/want a GP with experience in mental health issues then search the BB site. Go to the tabs at the top of the page and click on Get Support/Find a Professional. You will find a list of these GPs. The list is searchable by postcode. My GP is very good with mental health and has been an enormous help. I also see a psychologist.

I feel sad that you have struggled for so long on your own. It must have been very difficult at times. The Black Dog is a bad beast when it gets in control of you and will take some time to bring to heel. I am surprised you have only been prescribed one AD for the whole term of your depression. Usually after a period of time, if the drug does not work then doctor will try another.

It is important that you have an AD that works. However, you are trialling the ketamine and you say it is helping. The thing to remember is that medication alone will not get you well. You need a whole mind and body change to move on. Have any of your psychs tried any therapies?

How are you going with diet and sleeping? Not that I am a shining example of good dietary practice. At the moment I get tired quite easily as I am in the middle of radiation treatment. Hopefully, once it is over I will be more alert and bang goes my excuse for lazing around.

Please continue to write in.

Cheers
Mary

[Caiphus]

I've been prescribed a lot more than that, practically every SSRI, NARI and SNRI.  Some were better than others but they all seem to lose their efficacy after a period of time.Diet fluctuates, but it is better now than it should have been.

The most recent course of AD made me put on a about 15 kgs (although I'm tall with a slim build normally so it has just taken me to a medium build... not a huge dent to my confidence) and at the moment I am going to the gym quite regularly with a trainer... I don't seem to get the endorphin rush that exercise is supposed to give you due to the anhedonia but I have gotten quite good at putting things into my routine if I have to be accountable to another person.

Hopefully as that AD finishes moving out of my system my hormones rebalance and the weight comes off.I think I get ok sleep generally anyway - at least most of the time.  I wake up a fair bit through the night but most of the time I can get to sleep relatively easily and my sleep is quite deep and difficult to disturb when I do.

Moving off the SSRI I have transitioned to a lesser known and newer AD that works on melatonin rather than serotonin so that should improve my sleep even more (at least slow wave anyway) and have the double whammy effect of increasing HGH through better quality slow wave sleep which should help my body composition reconfiguration.

On the therapy front CBT seems ubiquitous now and very difficult to find therapists that use a different approach. CBT has been continuously underwhelming and ineffective in my treatment. My hyperactive brain finds ways to outsmart any cognitive reprogramming and anhedonia makes the behavioural therapy component ineffective.  I've just been referred to a psychologist who uses a different mode so hopefully they will accept the mental health plan and bulk bill with minimal gap.

It must be incredibly difficult to stay positive during radiation therapy at the best of times and if you had a pre-existing mental illness, I hope you have the strong support network to help you get through when your struggling to find the internal strength.  All the best!

[White_Rose]

Dear Caiphus

Many thanks for your reply and for your good wishes. I am finding it's not the radiation part that bothers me so much as the daily journey to the hospital. I have friends who are chauffeuring me every day which is really terrific. It is at times like this you discover how many people really care. However I have been told that as the treatments progress so I will become increasingly tired. Not looking forward to that much but only two more weeks to go.

I have been managing depression caused by relentless bullying. I had thought I was moving past it but it came back to haunt me some weeks ago and as this coincided with the cancer diagnosis I pretty much fell in a heap. I see a psychologist who has helped me a great deal. He proposed CBT but I had experienced this many years and did not understand what it was or how it worked. This psych used a far more simple version which I have found very helpful.

There are quite a few people on this site using ACT, Acceptance and Commitment Therapy. I have no idea what this entails other than mindfulness being one of the components. I am a big fan of mindfulness. I am also meditator. Have you tried meditation? What I find with meditation is that you have to let all other thoughts go and focus on your mantra only. Not as easy as it sounds. The usual description is that it is a simple process but not easy.

I do recommend this because of the letting go. It doesn't matter how good your brain is or what you want to do or thinks, the requirement is to say your mantra and do or think nothing else. Simple, not easy. If you would like to know more search for Australian Christian Meditation. The difference between therapies and mediation is that you are not required to do anything except cultivate a daily habit of meditation and the discipline to continue even when 'nothing' seems to be happening.

Once you find the web site there will be a link to meditation groups who will welcome you and help you on your journey. End of advert.

If you have not tried mindfulness and/or meditation I suggest you see how it works for you. If your brain is constantly hyperactive these processes may help to you to slow down and focus on what is happening rather than what to do. One of the things I say to people is to stop looking too far ahead and concentrate on today, or the next hour. Next week is too far away as is next month or next year.

I would like to continue this conversation with you.

Cheers

Mary