Positive Awareness+ Medical Intervention (Spravato) + Lifestyle

Thanks for sharing. I’d really like to see it.
On another note have you gotten relief from these treatments?
I am hearing about pros and cons.
Very hesitant to start this program thanks again.

@clutch
@dqg
From an objective point of view, on the MADRS--a depression scale--I've come from 38 to 22. In 2019--out of 60, I was in the low 50s.
Sometimes my husband or daughter stay with me during the treatments. I ask them to respond, too.
My lassitude--the effort of motivation--is the one that interests me the most. My assessment has gone from very subjective, very hard on myself to acknowledging the baby steps I've accomplished. I'm still my own worst enemy, but I can cut myself some slack. I don't live in a pig-sty, I'm not a slob. I live in organized clutter...no dead cats and no stacks of newspapers from floor to ceiling. Fewer self-deprecating comments about myself.
When I'm depressed, shut off and shut down, as I begin to awaken I want to do something entertaining: garden, crafts, interact with people.
In general, I don't mind people who care viewing the video.but I can't control that.
I don't want to open up myself to haters or precipitate undo negative comments or sarcasm.
I'm hoping the moderators guide the comments in the appropriate direction. . Like I said. It isn't remarkable. I sound enebriated but coherent...if you ever had an endoscopy or colonoscopy, it's the feeling as the sedation is initially introduced--only I don't go to sleep during the first phase--when the effects of Spravato are the most predominant.
A picture is worth 1000 words. Be kind...ahhh...an act of God. The file is too big...lololol

This is where I work on avoiding analysis paralysis...the lolol at the end of my last entry was a spontaneous reaction to the technical glitch. The irony of wanting to be perfect ...making the appropriate decision came down to being restricted to sending less than a 5MB file. Do the types listed allow a format for video?

I have treatment resistant depression. I considered the Spravato treatment but the process frightened me and also my doc charges $40,000 a year for it. Because another medicine was suggested and the cost was very high I didn’t want to do that either. So I enrolled in a study my doc was giving. It is the Vagus Nerve Stimulation study. In any event please talk about Spravato treatment. I am interested.

Regarding this Sprovato treatment questions I have how do I see this video?

@eczarniecki
@dqg
@clutch
Good morning
Regarding my video, apparently media 5MB or more cannot be sent to Mayo Connect. Even though I reduced the size of the video, it cannot be sent. It's not going to make any sense to send a photograph.
I created a "selfie" in which I explained that as I was talking, I was coherent.
For me, there are several parts to the REM administration of Spravato:
Triage: weight, temp, heart rate etc
Treatment room consists of a treatment room--visualize a typical medical treatment room: cabinets, sink, an exam table. The additions are a basic, vinyl recliner and a lamp with a low watt bulb. No white light. No TV.
I bring a blanket and pillow for personal comfort.
At Eastern Carolina Medical Center, one of three pharmacists with docorates, supervise my treatment.
BP taken
MADRS assessment (Google it to see the depression scale)
Time recorded, I am handed a Spravato nasal spray, and I administer 1 spray in each nostril. That's the full dose of 28mg...empty container.
5 minutes later, second dose administered by me. The effects of the medication are evident.
5 minutes later: third dose completes the full 84 mg.
In other posts, I have described the sensations that I experience during Phase I...40 minutes later, my BP is taken.
In the second phase, the medication is dissipating. I have water, a protein drink, a Granny Smith apple, and crackers in my survival kit. I usually eat or drink something.
I write in my journal. Sometimes I forget to turn off my phone and even answer my phone or text, if necessary.
40 minutes later, one of the pharmacists returns.
BP... in my normal range (or I cannot leave) and we exchange small talk and I go home. My husband or family member has to drive.
If you went to short-stay surgery or received sedation for a dental or endoscopic procedure--you would need a designated driver.
The video can be shelved. I was talking about Spravato and explaining that I am lucid, coherent and not crazy. My speech is mildly affected, "Fade to Black"
As the time passes, my words are no longer slurred,
my balance is intact, I walk to the bathroom...nothing remarkable. Nothing scary. Nothing stereotypical of a "trip."
I conducted my due diligence. My decision to receive Spravato treatments was not made out of impulsivity nor desperation.
I have treatment resistant depression with Major depression, Generalized anxiety, ADHD, & PTSD. PLUS, I have Atherosclerosis and 8 cardiac stents.
I did not exhaust all options of treatment.
I decided, rather than languishing for months, collectively years doing nothing,--that I decided to get out of my analysis paralysis. Commit or be committed.
I am engaged in my garden, my community, my family...,My house? Ehh!
BTW...my suicidal ideations have diminished.

@colleenyoung
To everyone,

About 20 years ago, I was seeing a psychiatrist who was gung-ho on the VNS implantation. A representative from the company was advocating for me. At the time, I was in a transitional phase--leaving the school system on disability, retaining my BCBS and entering into Medicare.
At the time, Medicare denied every attempt for coverage of VNS. ... "it is exploratory as a treatment for depression.)
Since then, for ME, I feel I dodged a bullet. VNS Patients I meet in passing rarely express remission of their depression. They still take psych drugs. ..anecdotal word of mouth.

Another device I considered is Transcranial Stimulation. Fayetteville is a medical desert. I would have had to travel daily for 6 weeks to receive the treatment. The psychiatrists in Fayetteville do not accept Medicare patients, which in my mind is discrimination and neglect...but they are entrepreneurs.

Finally, research with people with epilepsy (VNS for depression is a result of those studies) and specific surgical intervention within the brain is on the forefront. That may lead to surgical intervention for depression. My brain is too valuable to continue to be a guinea pig for ME, guessing and checking if a medication, a stimulation, a surgical excisement will or won't work for ME.

BTW...@clutch...I was needlessly worried about medical coverage regarding Spravato. My co-pay per month, for weekly treatments is $50.00 oooohhhhmmmm....

My husband and I have a routine. Very exciting: he goes to the farm store to buy dog food; he comes and gets me after Spravato; we go for supper at a restaurant, and then run a few errands on our way home.

I am not 100% of what I think is 100%, but I am better. Perfection is presumptuous.

I acknowledge that on a chart with pros and cons, I am experiencing more ✔️✔️✔️ pros with daily living skills--right out of a Transition Plan for Exceptional Children--and I am one at heart.

A young man in the neighborhood helped me create a fake garden bed near our community's entrance. We actually planted 4 tomatoes 🍅 2 Thai Pink Lady and 2 Gabrielle Grapes. If the neighbors commit to taking care of this baby bed, well...

Last year, during a mini-awakening, I planted succulents and perennials in our sign's planter. They are robust and flourishing.

I am taking advantage of my moral obligation to participate in life as this "Awakening" arises.
Yesterday, I loaded the dishwasher AND ran a load. I even washed the sink--all chores that people take for granted. But they are a struggle for me.

I pruned my azaleas. Getting rid of deadwood is therapeutic.

My positive awareness is as important as any medication I have to take, including those for BP and my basic chemistry panels. My lifestyle has changed...that is called a cliffhanger.

"...am not 100% of what I think is 100%, but I am better. Perfection is presumptuous.

I acknowledge that if I had a chart with pros and cons, I am experiencing more ✔️✔️✔️ in the pro column" (Me)

Within this group, I've been reaching out to those with treatment resistant depression and its shadow: suicidal ideations... "I wish I was dead...never born"...or worse!

I've talked about Esketamine aka Spravato.
Remember Spravato is NOT an anti-depressant. I take 125 mg Desipramine in combination with Spravato.
Yesterday, during my treatment, as I was answering the questions on the MADRS,

I realized that I could earnestly answer "1" as opposed to "6"... obsessed with dying, Get it over! What's the point?

Although I want to be Pollyanna--nothing is perfect. Lately, I've been experiencing a headache after the treatment...at least I can feel (as opposed to death). As always, I hope this too shall pass.
The other thing I've noticed is a pattern: I cry on Saturdays and Tuesdays...seems to be caused by an inane trigger. Once I weep, I'm OK.

A friend, who is wise, yet humble, shared these strong, yet comforting words with me:

Friend 1: "You can't worry about what people think .. there will ALWAYS be someone with an opinion. I think you have to be willing to accept yourself and be comfortable to know your own SELF WORTH-- that goes a long way"

Me: We are invaluable! Now let's have a good cry...🙏🏽 ❤️

😿 "Tears are a gift of grace from God, and their fruit is always joy. Weeping arises from the heart and signifies an open and softened heart."

Friend 2 was here. She asked me why I feel depressed when I have a good husband, a house, an education...

Then we talked about her daughter-in-law's suicide. She asked me "why" I take Spravato every Friday.
She said, "I wish I could give you a pill that would cheer you up." Right out of the Mother's play book.
Ironically, that made me laugh...

I am very fortunate to have such powerful friends...

And...a 1! Not a 6

@audriana that is wonderful news that you are seeing that progress and that you have such supportive friends with whom you can openly share your journey. What do you feel has changed since your MADRS answer of 6 to now a 1 that you may be able to attribute this positive change?

@amandajro
Nothing simple or quick.
Perseverance, time, patience...when the warped thinking retreats.
This is my second treatment cycle with Spravato. First was initiated in 2019 and I responded well. I started with Desipramine as the antidepressant. I reached a maintenance dose, Then circumstances beyond my control suddenly discontinued the Spravato. Treatments.
This time, November 2021, Janssen's Spravato protocol wanted me on an SSRI. preferably Zoloft. As indicated in review of my Genesite testing, SSRIs contribute to the suicidal ideations in ME. I've been on the classics from A to Z.
So I asked my doctor to prescribe Desipramine and he has slowly titrated the dose.
There are times when I've been really discouraged because "it" doesn't seem to be kicking in. It--that feeling of feeling like ME.. not on death mode.
This past Friday, I felt I honestly had scored a one...a very fine line, almost indistinguishable from a zero.
My affect is not without some glitches, but it is so much better.
When I was recognized in the May Spotlight, I realized I also experienced some other emotions: excitement, enthusiasm, fun, empathy, sincerity, caring--as a recipient of others' feedback...and I initially asked, "Why me?" I know the CBT is working, too because, "Why not me?"...that's not conceit. That's acknowledging my self-worth and I believe in Paying It Forward.