I started IV Ketamine this past November. I’m doing the treatment every week (for now). I’m hoping to be able to change that to once every three weeks fairly soon. I was resistant to trying IV Ketamine for a while. Then, my depression got extremely bad, and none of my meds or treatments were helping, so I finally decided to give IV Ketamine a try. It works so well, I wish I tried it a while ago.
The IV Ketamine is working very well for me. It’s the reason that I can finally stop the ECT treatments. I’ve actually already started to wean off of ECT, thank goodness.
I have an appointment with my psychiatrist later today. I’m all ready for it; I have my list of things I want to talk to him already in my purse so I don’t forget it. Now, all I have to do is get through the appointment. I always wonder what he thinks of me. Does he think I’m ridiculous because there’s nothing that can help me regularly? Probably not; he is the one that diagnosed me as bipolar 1, rapid cycling and treatment resistant. I probably think I’m ridiculous more than other people do. I think those type of things about myself more than other people do. Well, here’s to hoping the appointment goes well. I’ll let you know how it goes.
I keep trying, over and over again. If it doesn’t work out the first time, I try again. Sometimes it may take me a while, but it’s important not to give up. This can extend to anything in life. Just keep putting one foot in front of the other.
Right now, I’m just trying to get my medications right. In the past 6 months, I went on Clozapine slowly, I went off of Mirapex and then back on Mirapex, I went off of Deplin, and I also stopped doing ECT treatments. I’ve done almost everything my psychiatrist suggested. The only thing I haven’t tried is IV Ketamine; I’m leaving that as an absolute last resort. My emotional state goes up and down, but it hasn’t been healthy or steady for a very long time, probably about 7 or 8 years.
No matter how bad it gets, I never give up. I may not be happy to do certain treatments, but I try. I give each treatment enough time to work before deciding if it’s right for me or not. This time, I’m going to give the Mirapex another couple of weeks before deciding if I need to try something else, which would be IV Ketamine. The most important thing is that I don’t give up before the miracle happens.
My psychiatrist has categorized me as treatment resistant. Basically, that means that I don’t respond to at least two standard treatments. It means I’m non-responsive to the normal treatments that usually work for others. There are a lot of medications that I’ve tried that don’t work for me. I also tried ECT, which worked for a while, but after quite some time it became too much for me to handle.
No matter what, I keep trying, even if I’m not getting positive results. If I don’t try, then there’s no way to find a solution. By trying to work at it, there’s a possibility, no matter how big or small, that something good could come out of it. At least I’m only considered treatment resistant, and not treatment intolerant.
The other day I made the decision to stop my ECT treatments and to increase by Clozapine dosage. I’m currently at 200mg and will be increasing my dose by 25mg each week until I reach 400mg. This was one of the options my psychiatrist gave me. Another option was to go back to doing ECT three times a week, but I’m not willing to do that at this point. The third option my psychiatrist gave me was to do IV Ketamine. He has been offering this as an option for many months now, but it’s not something I want to do.
IV Ketamine scares me for a couple of reasons. I used to get high off of Ketamine when I was using. That was a long time ago, and I know that abusing Ketamine and using IV Ketamine are two completely different things; the side effects of IV Ketamine are nothing like the effects of getting high off of it. My biggest fear of trying IV Ketamine is the possibility of dissociation. When I would use Ketamine to get high, I would take so much that I would slip into what’s called a ‘k-hole’, which is pretty much a dissociative state. I couldn’t move or speak, but I could still feel everything that was going on around me. The possibility of dissociating scares me, it triggers my PTSD. I always need to be able to protect myself, and dissociation would take that away from me. Plus, the treatments are especially expensive.
The use of IV Ketamine is highly effective, and it works very quickly. It is known to show improvements by the end of the infusion. Maybe my reasons for not trying it are ridiculous, but they are my reasons. I’m not saying that I’ll never try IV Ketamine; I would just prefer to leave it as an absolute last resort.
Treatment-resistant bipolar, also known as med-resistant, is something that most of us know too much about. Sadly, it’s extremely common. Being diagnosed as treatment-resistant generally depends on the number of medications a person has tried during the phase that individual is in. Many individuals have been through all sorts of different medications without much success. And then of course, if a person finally finds a medication that helps even a little, it comes with side effects that are too much to handle. I have been considered treatment-resistant by my doctors many times throughout my diagnosis. I have taken so many medications that I’ve lost track of them all. I’ve even lost track of the horrible side effects. I know that for me, Abilify sends me into a huge manic episode, Depakote causes me to lose my hair, and I gained 80 pounds on Risperdal. Those are just a couple examples of medications that I couldn’t handle.
Treatment-resistant doesn’t mean that there’s no answer; there are several individuals that are treatment-resistant that have gone into ‘remission’ for multiple years. I am one of those individuals. Somehow, I was able to live a regular life, work a full-time job, and have a full-time social life. I don’t know what happened or what changed, but after a little more than 2 years, something changed. I was still taking my medication and seeing my doctors, but it was as if I was a ticking time bomb. Then I exploded into such a massive manic phase that I had to leave my job and go live with family. I haven’t been stable since that time, but I do know it’s possible. Sometimes I wonder if I can ever get back to the place in life that I was at before. Honestly, I don’t know if it will or will not happen, but I haven’t given up.
There is always hope, even for those that are treatment-resistant. New treatments and medications are always coming out that could help. Sometimes, a certain combination of medications or treatments is the key to remission. It’s not easy to be patient, or willing to try new treatments, but you never know when one of these new methods will be the key to our health. I am always willing to research and usually try new treatments and medications. I am doing ECTs, electroconvulsive therapy, every month (I’m doing the maintenance treatments at this point), and I am doing a rechallenge of the Clozapine medication. The ECTs helped me get out of a major depressive episode. The Clozapine is supposed to help take away my suicidal ideations; it’s too soon to tell how effective it will be. My conclusion regarding treatment-resistant bipolar is that you never know when some new treatment or medication is going to help; don’t give up before the miracle happens.