Tuesday, April 29, 2014

Repetitive Stimulation (!!)

Back in the day, before Freud made psychoanalysis so popular we can now joke about the libido with abandon, women suffering from neurotic disorders had quite a small range of treatments available to them. For one example, a woman could pay a series of visits to her physician, during which he would use a specialized apparatus to stimulate her nether-regions until she achieved climax.

Sadly, this is no longer an option.

In all seriousness, this is not the kind of repetitive stimulation I've been prescribed.

Repetitive Transcranial Magnetic Stimulation, or RTMS, is a relatively new procedure approved for cases of treatment-resistant major depressive disorder. If all goes according to plan, I'll be starting an accelerated course of RTMS at the Douglas hospital beginning on Monday, consisting of two treatments a day, five days a week, for three weeks. The hope is that it will be as effective as ECT, but without any of the effects to short-term memory. Just in case I do forget anything, please be sure to remind me at every available opportunity that I am a naturally-blonde, multimillionaire named Sarah. I am also very, very good at math.

Unlike ECT, RTMS is not meant to induce seizures, and that's one of the things I'll be monitored closely for during treatment. I need to have some of my earrings removed so they don't get ripped out of my head by the powerful magnets, and I need to wear earplugs. I also need to get an answer back from my short-term disability insurance and my company's HR department stating that my leave of absence for this treatment has been approved. I'm not sure what I'll do if it turns out they're turning me down. On the one hand, I like this job and the team I work with, and on a practical level I need it if I'm going to afford food and medication, not to mention housing. On the other, without successful treatment I will continue to suffer from crippling, suicidal depression until, eventually, I succumb to my illness and die.

This treatment is part of a clinical trial, so nothing else about my medication regimen can change throughout its duration. To give you some perspective, I've been on a waiting list since my initial assessment in early February, and my condition began to noticeably deteriorate in late September. I feel like I've waited long enough and, frankly, suffered longer than should have been acceptable.

I am terrified of this treatment. Terrified that I won't get the chance to do it and will be stuck like this forever. Scared that it won't work, and scared that it will. Worried about whether I'll have time off once it's completed to consolidate my recovery, or if I'll be working full-time immediately and all the risks that will entail. I don't know what will happen to my hospital-team's strategy of having me complete therapy to deal with unresolved trauma since I lost my psychologist, and there's not enough time in my progressive-return-to-work timeline to begin treatment again even if I had been assigned a new therapist right away. It's all very...unsettling.

I would love for RTMS to lift me out of the chronic depression I've been living with for the last 11-or-so years. What I need it to do is break the back of this acute episode so I can begin the long climb upward to a place of stability. Regardless of how it turns out, it's unrealistic to think that I don't have a lot of work to do on myself when this is settled. A decade of illness leaves its mark, and health isn't something that I remember how to live with, let alone feel comfortable with. I'm not really sure who I am anymore, either with this disease or without it. I understand that this illness is, by nature, chronic, and I'm not sure I've ever dealt with the reality of that, or grieved the life I will not be able to have. These are all things I'm hoping to explore, once I can breathe again.

In the meantime, I take comfort in the fact that cauterizing a woman's clitoris in order to dispel neuroses is a treatment that has, thankfully, gone as much out of favor as masturbating her to orgasm has. Bring on the magnets!