Another depression log
Well.
I seem to have driven yet another therapist into recommending drastic steps as a 'Hail Mary' sort of option.
Last session, he started talking about TMS and the various logistical complications (insurance doesn't cover it, e.g.) and its possible benefits. Unfortunately, under 'possible benefits,' the answers are sort of hazy. They all seem to boil down to 'step 3: profit!' and not much else. I guess we don't really know exactly how psychopharmaceuticals work either - I mean, we can tie them to a physiological difference (serotonin levels, etc.) but we can't postively follow the train back to why these changes make people more or less depressed. We just don't know enough about how the brain works.
This time, I seem to have driven him to this suggestion because his model of therapy seems to be incompatible with my particular pathology. In other terms, my problem prevents me from deriving any benefit from talk therapy, at least as he implements it.
Do I just buy that explanation? Looked at one way, I don't have much choice, I guess - he's the therapist, after all.
Part of this is no doubt because my set of problems are (like so many others) rooted in things that happened in my childhood - and one of the things that happened in my childhood was that I was raised by a psychiatrist. As a result of that, large chunks of my personality and behavior patterns evolved to 'ward off' the normal methodologies and techniques of the therapist - because, after all, most kids find ways to keep their moms out of their lives, regardless of what tools those moms have at their disposal.
So it's possible that my inability to derive benefit from talk therapy - or, talk therapy's inability (so far) to help me - comes from that.
The problem is that we seem to live in a fucking Dark Age when it comes to psychiatric medicine. Honestly. I mean, the steps that seem to be followed, from my experience, are:
- Talk therapy, which is a very very 'art-like' process, and has severe limitations
- If that doesn't work, or in addition, medications whose effects we can't really follow precisely but seem to work sometimes
- If that doesn't work, jump to TMS, which is a recent option, because otherwise we would go right to
- ECT, which relies on inducing seizure and unconsciousness in a manner quite like the workings of the electric chair in order to induce some sort of dramatic change. Um, thanks, but no thanks.
And that's it.
The Dark Fucking Ages of a medical specialty.