Rejection letter from Janssen CarePath re Spravato

Thanks @amandajro I'm glad you repositioned my entry so people can understand the big picture.

@amandajro Do you think I would be helping others if I provide entries about my journey?

Several years ago, during an inpatient hospitalization, I saw one of the psychiatrists on staff @ BHC. When he initiated a discussion with me, he commented on my lack of Hope. He said, "According to research, Hope is necessary. in order to improve." He caught my attention with that simple phrase: according to research.
On a more poignant note...
When I returned to the recreation room, I looked out the window and saw a blue bird in the bush...the blue bird of happiness. Everyone in the room was excited...just like in a scene from K Pax...a movie about a character who had a mental illness.
My aunt and uncle gave me a hand blown glass blue bird of happiness...lol...life...gotta love it!

I recently found a window vinyl decal to put on my car. It says, "once you choose hope, anything is possible" I love that phrase! And hoping that someone who see it will be inspired.
Ginger

Hello everyone! I hope you are well. I apologize. I'm forgetful with names.
Today, 11/24/21, I received my 6th Spravato treatment. On the MADRS--a depression scale-- I improved from 34 to 18. Dr. Andrew was excited for me!
The whole REMS protocol compliance is so much better than the way I was previously receiving Spravato.
As far as the individual treatments, nothing remarkable or compelling to report. No insightful solutions regarding climate change or curing anything. Sometimes I make entries in my journal. By my handwriting, I can track the progress in the different phases. Sometimes I converse. Sometimes I just sink into my pillow and wrap myself with my comforter.
I'm tolerating the treatments without adverse effects. Knock on wood.
I continue using a multi-faceted approach directed at my depression which is intertwined with anxiety, life-long insomnia and other sleep disorders, ADHD, and PTSD.
• I continue to see my primary psychiatrist for med checks, every 2-3 weeks. As of Monday, rather than taking 75 mg Zoloft at night, I'm taking 25mg 3 times daily.
• My psychiatrist has equated my anxiety to being on a hamster wheel--expending so much mental energy without anything to show for it other than analysis-paralysis. He's added something new to the equation. He agrees that I have Generalized anxiety; however it's exacerbated by "free-floating anxiety." Google it...it's interesting and its attributes fit me perfectly. Just knowing what "it" is, is a comfort.
• My psychiatrist referred me to the CFV Sleep Clinic to see a psychotherapist specializing in Cognitive Behavioral Therapy for my anxiety and insomnia. I've seen her 3 times and will continue as if I'm taking a course. There will be a conclusion. In the last month, I've taken Belsomra twice. For years, I was taking some type of sleep med...talk about a cautionary tale.
• I continue to talk telephonically to my regular therapist. She kept me out of the Niagara Falls last June.
Collectively, we stagger appointments so I'm receiving equally distributed care from my providers.
• I continue to receive care from my primary physician. We keep a close eye on my thyroid levels and other stuff.
• I took a hiatus from my gardening. Actually, about a month + ago, I sort of froze in mid-swing, like the Tin Man, and spent too much time in bed. Yesterday, I woke up at 6, got out of bed at 7, and went outside at 8. I spent a few hours here and there and planted daffodil, crocus, and little "grape" bulbs. "It" will get better. I'm due an "Awakening."
There's a bunch of other stuff in my tool box that I access. As I said, I use a multi-faceted approach. I don't depend solely on medications. @clutch commented on the cautionary tale about meds, their side effects, and the issues of withdrawal.
I know this entry is long. I know some people don't like looooong entries.
When I'm in the mood, I like to write. Sometimes it's a lonely activity. It makes me feel less lonely knowing someone might read this. It makes me feel better hoping my words might help someone.
BTW... While gardening, I tipped over a rock and woke up a hibernating Gecko...my little Buddy. I wanted to make sure he was okay before I returned him to the "warmth" of his home to continue his slumber...
Good night. Sweet dreams.
Ttyl

Bear with me. I've been experiencing a major depression for months. It seems as if in September, I froze in mid air, like the Tin Man...or Forest Gump, when he just stopped running.
"What's wrong? How are you feeling?"
"I'm depressed."
It sounds so lame. The sertraline just doesn't seem to be effective. In the past I notice that the closer I get to the therapeutic dose with SSRIs, the more depressed I become and then the suicidal ideations manifest themselves. The Spravato is helping control the SIs, but the "sertraline" isn't working to help with lassitude. Years ago, I was taking it when it was Zoloft.
I've been on it for over 3 months now and the Spravato for 6 weeks. I see my psychiatrist every two weeks.. This Monday...maybe back to the drawing board. I need him to look up my records and see what antidepressant I was taking back in 2019--concurrently with Spravato.
Dr. Andrew Blum, at ECMC, is a Pharmacist and he has been supervising my administration of the Spravato. Their REMS program is stellar compared to the care I was receiving in Fayetteville. On the MADRA scale, I am improving--from the mid 30s to 18...baby steps.
BTW, in Benson--no white light--no TV; low watt, warm light bulb and supervision throughout the first phase and my BP is stable. Knock on wood-- no adverse reactions during treatments. I usually eat an apple and drink a protein shake after phase II. Today, I forgot my apple. By the time I got home. I craved croissants & Combos
lol ...my glucose dropped down to 45--won't do that again...smh.
I yearn to feel that I am "flourishing." I have to be patient... On Thursday, I ran a few errands--something I used to take for granted. Now, they are achievable milestones.
Oh-- I haven't taken Ambien on a nightly basis,since May--after about 20 years, nor Belsomra. I started CBT about 2 months ago for insomnia and anxiety...another set of baby steps.

Keep up the good fight. Those baby steps add up.

@audriana So good to hear from you. Glad to know that there is progress albeit small increments at times. Curious as to the CBT-I therapy. How has that impacted your sleep? How did you go from Belsomra/Ambien regularly to not needing hardly any at all? That’s real progress in my book!!
Loved hearing your story. Keep up the baby steps.

12/20/21 multi-pronged approach to insomnia & anxiety

Consumer Report about Belsomra; subjects fell asleep 6 minutes earlier than control; 20 mg most effective, but daytime drowsiness
CBT:
Self soothing techniques. After a "startle" Awakening as a prelude to a night terror, I actually tell myself everything will be ok; even sing to myself, "Hush-a-by, don't you cry..."
Permission to use anti-anxiety med as tool, when necessary.
3-3-3 strategy, grounded by identifying 3 sounds, seeing 3 items, moving 3 body parts
Journaling as a method of controlling impulsivity--sleep on it--but limit time
Restricted caffeine
Aromatherapy
Ambien: too many weird, dangerous behaviors, plus amnesia
Belsomra & Ambien: did not awaken refreshed
Time management
Diaphragmatic Deep Breathing
Visualization, biofeedback, & signal word
Picture what my anxiety looks like and "dispose"
Art therapy
Do not disturb & airplane mode on phone; landlines' ringers off
Timer on tv
Even using behavior modification nocturia--disturbance to programmed peeing...lol...tmi...smh
I even replaced my "olde" mattress

Brainstormed @clutch to generate what I've been working on for the last few months.
My psychiatrist referred me to a psychotherapist, specializing in CBT. Anxiety & Insomnia.
My doctor believes if I can address the anxiety. then the insomnia & depression will decrease.
Thanks for the feedback, questions and encouragement. I especially like your phrase, "cautionary tale. "
BTW...Dr. reviewed the results from the Genesite testing in 2018. My intuition about SSRIs was correct. When I was on Spravato, initially, I was taking desipramine. I have a genetic anomaly that prevents me from responding to SSRIs in comparison to research predictions....just a minor complication: heart arrhythmia & higher BP...monitor and adjust

Good morning.
Something I've learned to acknowledge is that psychiatric issues often mask other health issues.
I finally changed cardiologists after 20 years. The doctor was effective, but during the last 5 years, I rarely saw him. I saw a PA who insisted my complaints were due to my psych meds. I talked to the doctor, the office manager, and the PA.
Bottom line, I was "dragging" because my heart rate was 24--nothing to do with psych meds--everything to do with Coreg--a BP med. Once it was discontinued, my HR has been fine.
Now, I use a half dose 2 hours prior to a Spravato treatment. That's it.