Saturday, April 6, 2019
Here Comes The Sun
In my previous blog post I talked about how discouraged I was because in the four months since having my Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) for my treatment resistant depression I hadn't had any improvement and I mentioned that I probably wouldn't be posting again until after my 6 month follow-up appointment unless something changed. Well, I am pleased to report that after years of having a steadily increasing depression, I have had an improvement in my mood over the past two and a half weeks.
At my last follow-up appointment, Dr. Levitt, the psychiatrist for the study in which I am taking part, gave four suggestions for changes in my medication that may help me. The first suggestion that we tried made no change in my mood, so we abandoned that. The second suggestion that he made was to increase the dosage of the medication that I have been on. I have been on the medication Fetzima for a couple of years now. I have been taking 120 mg for that entire time. That is the maximum recommended dosage for Fetzima and my psychiatrist was hesitant to give me a higher dose because Fetzima is a relatively new medication and he hasn't had anyone on that high of a dose yet and neither had any of his colleagues. I tend to get bad side effects from medications, so he didn't want to give me a dose that he had no experience with. However, Fetzima was one of the few medications that I was able to take at full dose without any side effects and it seemed to help me with my anxiety, so we continued to use it at 120 mg. Dr. Levitt suggested that we increase it gradually to 160 mg or 180 mg to see if it gave me any more positive results and since he had experience with prescribing it at that high of a dose, my psychiatrist agreed to increase it.
We first increased my dose to 140 mg. The next day I noticed a significant change in my mood. I was no longer crying all the time. I wasn't saying "I'm not doing well" or "I feel bad" to my wife all of the time. I didn't spend all day thinking to myself "I feel horrible" or "I'm not feeling well", instead I was thinking to myself "What am I feeling?" and "Why am I feeling this way?". I didn't feel sad all of the time. Thus, it was a pretty significant change in my mood. The change lasted for the full two weeks until my next psychiatrist appointment.
My psychiatrist uses the Quick Inventory of Depressive Symptomatology (QIDS) test to determine how depressed I am at each appointment. Over the past several years my score has always been in the 19-21 range, which scores as Severe Depression or Very Severe Depression. After increasing my Fetzima dose to 140 mg I scored at 14, which rates as Moderate Depression. Therefore, the increase in my mood was significant.
It's hard to know what caused the improvement. Was it just the increase in my dose of Fetzima? Is it the MRgFUS finally kicking in? Is it a combination of the two? I tend to think that it was a combination of the two that has brought about this change.
Even though I have had a significant improvement in my mood, it is important not to overstate how well I am doing. I am still down. I am still in a depression. I am not feeling happy yet. Hence, at my last appointment, my psychiatrist increased my dose to 160 mg. Unfortunately, the increase in dose this time did not have the immediate impact that the increase to 140 mg had. I haven't noticed any change since the increase to 160 mg. It may take time, or I may have to increase it to 180 mg, or I may not have any further improvement, or I may slip back into my severe depression. It is hard to know.
At this point however, I am glad to just be experiencing this improvement in my mood and hope that it continues into the future.
Monday, March 11, 2019
Cold As Ice
I haven't made a post on this blog in quite a while. That is because there hasn't been too much to report. It is now almost four months since I had the Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) for my treatment resistant depression and I have not noticed any improvement in my mood. As I mentioned in a previous blog post, my anxiety had seemed to decrease for a while, but even that modest gain seems to have been lost now. My anxiety seems to be back to where it was previously, and that is very discouraging.
In my last blog post I mentioned that the psychiatrist for the study in which I am taking part, Dr. Levitt, had suggested four modifications in my medications that my psychiatrist and I could try. We have tried one of them, but it hasn't made any difference in my mood thus far, which is very discouraging. My psychiatrist had questions for Dr. Levitt about the other three suggestions that he made, so they had to discuss them. I will be meeting with my psychiatrist again next week, so I should get an update as to how feasible those other three suggestions are.
The past few days, in addition to my depression, I have been battling a bad cold. I don't know if it is the depression that makes me more needy when I get sick, or if I am just a needy person to begin with, but I really find that when I get sick I become more needy. It is really difficult to try to fight off a cold while you are being held down by depression at the same time. It's all the more difficult because the depression saps all of my motivation and leaves me feeling very lethargic, and when you add a cold to that I really don't feel like doing anything. Staying in bed definitely seems like the best option.
That's where I am right now. Nothing has really improved and I may have regressed in terms of my anxiety. Getting better seems as far away now as it ever has. My posts on this blog will probably become more infrequent as there isn't much to report on now that we are more than three months post-surgery and I am not getting better very quickly. My next follow-up appointment at Sunnybrook hospital is at the 6 month mark and unless something drastic happens before then I may not post until that follow-up.
In my last blog post I mentioned that the psychiatrist for the study in which I am taking part, Dr. Levitt, had suggested four modifications in my medications that my psychiatrist and I could try. We have tried one of them, but it hasn't made any difference in my mood thus far, which is very discouraging. My psychiatrist had questions for Dr. Levitt about the other three suggestions that he made, so they had to discuss them. I will be meeting with my psychiatrist again next week, so I should get an update as to how feasible those other three suggestions are.
The past few days, in addition to my depression, I have been battling a bad cold. I don't know if it is the depression that makes me more needy when I get sick, or if I am just a needy person to begin with, but I really find that when I get sick I become more needy. It is really difficult to try to fight off a cold while you are being held down by depression at the same time. It's all the more difficult because the depression saps all of my motivation and leaves me feeling very lethargic, and when you add a cold to that I really don't feel like doing anything. Staying in bed definitely seems like the best option.
That's where I am right now. Nothing has really improved and I may have regressed in terms of my anxiety. Getting better seems as far away now as it ever has. My posts on this blog will probably become more infrequent as there isn't much to report on now that we are more than three months post-surgery and I am not getting better very quickly. My next follow-up appointment at Sunnybrook hospital is at the 6 month mark and unless something drastic happens before then I may not post until that follow-up.
Wednesday, February 13, 2019
MRgFUS 3 Month Follow-Up
Yesterday, on a very snowy and icy day in Toronto, I had the three month follow-up appointments for the Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) that I had to help treat my depression. It was a day filled with tests and meetings with doctors as they tried to see how I am doing three months after having my surgery. From my point of view, my depression has been getting worse since my last follow-up appointment in December. I have had very low mood and feelings of hopelessness and worthlessness. Thus, I was not expecting much to come out of this day of testing and meetings.
The day started out with some psychiatric scales testing. They do this testing at every follow-up appointment to see if my depression is improving or not. In other words, to see if the surgery has been a success or not. The testing primarily consisted of three scales to determine the severity of my depression. As I wrote back when I originally did the psychiatric scales, all of the tests that I did at the time of my surgery showed that I was suffering from severe depression. The first test that we did was the Hamilton Rating Scale for Depression (HAM-D). Originally when I had my surgery, I received a score of 25 on this test. In December, my score improved slightly to 24. Yesterday, my score again improved slightly to 23. Scores of greater than or equal to 23 indicate a very severe depression. Thus, I have continued to score a slight improvement according to this test. The second test that I did was the Montgomery–Åsberg Depression Rating Scale (MADRS). Originally when I had my surgery, I received a score of 36 on this test. In December, my score got worse to 38. Yesterday, my score improved somewhat to a value of 34. Scores of greater than 34 indicate severe depression. So, I am getting slightly better according to this test, but still scoring in the level of severe depression. Finally I did the Beck Depression Inventory (BDI). Originally when I had my surgery, I received a score of 36 on this test. In December, my score got worse slightly to a level of 37. Yesterday, my score got even worse to a level of 40. Scores of greater than or equal to 29 indicate severe depression. Thus, I am getting slightly worse according to this test. Overall, these test scores indicate that I am not improving greatly, but not getting substantially worse, which doesn't quite match how I am feeling as I felt my depression get worse. Hence, the surgery has had no real effect on me as of yet, I am still suffering from severe depression.
Next I had an MRI performed to see what is happening with the lesions in my brain that were created as a result of the surgery. At this point I am well beyond the time frame that they would be worried about severe neurological symptoms appearing. However, they do want to take a look at the lesions as they can shrink as they heal. When they are first created, they are swollen and quite large. As time progresses, they begin to heal up and shrink. They want to see how much they have shrunk and if they are still there.
Then I had a meeting with the neurologist for the research study in which I am taking part, Dr. Nir Lipsman. The first comment that he had upon seeing me was that my hair had grown back. I'm not sure what he was expecting, but it would be more worth mentioning if my hair hadn't grown back and I was still bald. Anyway, he said that he had a chance to take a quick look at my MRI images, and, in fact, the lesions had decreased in size somewhat. As I said this is to be expected and doesn't affect the probability of a successful outcome. He reassured me that we are still early, only three months post-surgery, and that it can take up to a year to see any results. Another thing that he said that was reassuring was that they viewed treatment-resistant depression as a separate condition from regular depression and that they do not view my surgery as a final attempt at getting better. They view the surgery as simply the first attempt. If the surgery does not work out, there are other things that they can try to cure me. That made me feel better.
Finally, I had an appointment with the psychiatrist for the research study in which I am taking part, Dr. Anthony Levitt. I mentioned to him that I had noticed my anxiety had somewhat improved (as I mentioned in a previous blog post), while my depression had gotten somewhat worse. He said that this was a good sign. It seems that the surgery works on a pathway in the brain that is primarily responsible for feelings of anxiety. Thus, it is expected that my anxiety would get better first and that my mood would then follow. That was a good thing to hear. He also said that the surgery may make me more likely to have positive results from anti-depressant drugs that didn't work in the past. He suggested four things for me and my psychiatrist to try to see if they improve my mood. My psychiatrist and I were under the impression that we couldn't make any changes to my medications until at least six months post-surgery, but he said I am free to make changes any time we see fit.
Overall, it was kind of a mixed bag of results from this three month follow-up. I am not improving, but that is not really expected yet, and some encouraging words from the study doctors. I guess I just have to continue waiting and try some new medications to see if I get better.
The day started out with some psychiatric scales testing. They do this testing at every follow-up appointment to see if my depression is improving or not. In other words, to see if the surgery has been a success or not. The testing primarily consisted of three scales to determine the severity of my depression. As I wrote back when I originally did the psychiatric scales, all of the tests that I did at the time of my surgery showed that I was suffering from severe depression. The first test that we did was the Hamilton Rating Scale for Depression (HAM-D). Originally when I had my surgery, I received a score of 25 on this test. In December, my score improved slightly to 24. Yesterday, my score again improved slightly to 23. Scores of greater than or equal to 23 indicate a very severe depression. Thus, I have continued to score a slight improvement according to this test. The second test that I did was the Montgomery–Åsberg Depression Rating Scale (MADRS). Originally when I had my surgery, I received a score of 36 on this test. In December, my score got worse to 38. Yesterday, my score improved somewhat to a value of 34. Scores of greater than 34 indicate severe depression. So, I am getting slightly better according to this test, but still scoring in the level of severe depression. Finally I did the Beck Depression Inventory (BDI). Originally when I had my surgery, I received a score of 36 on this test. In December, my score got worse slightly to a level of 37. Yesterday, my score got even worse to a level of 40. Scores of greater than or equal to 29 indicate severe depression. Thus, I am getting slightly worse according to this test. Overall, these test scores indicate that I am not improving greatly, but not getting substantially worse, which doesn't quite match how I am feeling as I felt my depression get worse. Hence, the surgery has had no real effect on me as of yet, I am still suffering from severe depression.
Next I had an MRI performed to see what is happening with the lesions in my brain that were created as a result of the surgery. At this point I am well beyond the time frame that they would be worried about severe neurological symptoms appearing. However, they do want to take a look at the lesions as they can shrink as they heal. When they are first created, they are swollen and quite large. As time progresses, they begin to heal up and shrink. They want to see how much they have shrunk and if they are still there.
Then I had a meeting with the neurologist for the research study in which I am taking part, Dr. Nir Lipsman. The first comment that he had upon seeing me was that my hair had grown back. I'm not sure what he was expecting, but it would be more worth mentioning if my hair hadn't grown back and I was still bald. Anyway, he said that he had a chance to take a quick look at my MRI images, and, in fact, the lesions had decreased in size somewhat. As I said this is to be expected and doesn't affect the probability of a successful outcome. He reassured me that we are still early, only three months post-surgery, and that it can take up to a year to see any results. Another thing that he said that was reassuring was that they viewed treatment-resistant depression as a separate condition from regular depression and that they do not view my surgery as a final attempt at getting better. They view the surgery as simply the first attempt. If the surgery does not work out, there are other things that they can try to cure me. That made me feel better.
Finally, I had an appointment with the psychiatrist for the research study in which I am taking part, Dr. Anthony Levitt. I mentioned to him that I had noticed my anxiety had somewhat improved (as I mentioned in a previous blog post), while my depression had gotten somewhat worse. He said that this was a good sign. It seems that the surgery works on a pathway in the brain that is primarily responsible for feelings of anxiety. Thus, it is expected that my anxiety would get better first and that my mood would then follow. That was a good thing to hear. He also said that the surgery may make me more likely to have positive results from anti-depressant drugs that didn't work in the past. He suggested four things for me and my psychiatrist to try to see if they improve my mood. My psychiatrist and I were under the impression that we couldn't make any changes to my medications until at least six months post-surgery, but he said I am free to make changes any time we see fit.
Overall, it was kind of a mixed bag of results from this three month follow-up. I am not improving, but that is not really expected yet, and some encouraging words from the study doctors. I guess I just have to continue waiting and try some new medications to see if I get better.
Saturday, January 19, 2019
Two Months
Today is two months since I had my Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) for my Treatment Resistant Depression (TRD). I had hoped that I would have felt something improve by this point in time, but I haven't noticed any improvement. In fact, over the past couple of weeks, I would say that my depression has actually gotten worse.
As I keep saying, the doctors do not expect me to notice any improvement in my condition for at least three months to a year after having the surgery. Therefore, it is perhaps not surprising that I haven't noticed any change yet. However, my mood over the past couple of weeks has gotten worse, as I have noticed an increase in my lethargy and lack of motivation, as well as in my feelings of hopelessness, worthlessness and loneliness. I find it increasingly difficult to get through each day.
My wife, however, sees this as something positive. When we met with Dr. Levitt, the psychiatrist for the research project in which I am taking part, he said that often people get worse before they get better when they have this surgery. Thus, it is possible that what I am experiencing now is a prelude to me getting better at some point. On the other hand, it may just be that I am getting worse and that the surgery has had no effect. There is no way to tell and that is the hard part.
Another point that Dr. Levitt made was that the results of the surgery may be subtle. I may not get better from the surgery itself, but the surgery may make medications that haven't worked in the past start to work for me. Thus, at some point, if I don't get any better, I will have to start retrying all of the medications that I have tried before to see if something works now. That could take a long time.
I am scheduled in for my three month follow-up appointment on February 12. At that time I will meet with Dr. Levitt as well as the study neurosurgeon and I will have psychiatric scales done again to see if I am improving or not. Finally I will have an MRI to see what is happening with the lesions that they created during the surgery.
So, that's where I am after two months. I'm getting worse and not seeing any improvement. That may be a sign that I will get better, or it may not. I still have a long road ahead of me.
As I keep saying, the doctors do not expect me to notice any improvement in my condition for at least three months to a year after having the surgery. Therefore, it is perhaps not surprising that I haven't noticed any change yet. However, my mood over the past couple of weeks has gotten worse, as I have noticed an increase in my lethargy and lack of motivation, as well as in my feelings of hopelessness, worthlessness and loneliness. I find it increasingly difficult to get through each day.
My wife, however, sees this as something positive. When we met with Dr. Levitt, the psychiatrist for the research project in which I am taking part, he said that often people get worse before they get better when they have this surgery. Thus, it is possible that what I am experiencing now is a prelude to me getting better at some point. On the other hand, it may just be that I am getting worse and that the surgery has had no effect. There is no way to tell and that is the hard part.
Another point that Dr. Levitt made was that the results of the surgery may be subtle. I may not get better from the surgery itself, but the surgery may make medications that haven't worked in the past start to work for me. Thus, at some point, if I don't get any better, I will have to start retrying all of the medications that I have tried before to see if something works now. That could take a long time.
I am scheduled in for my three month follow-up appointment on February 12. At that time I will meet with Dr. Levitt as well as the study neurosurgeon and I will have psychiatric scales done again to see if I am improving or not. Finally I will have an MRI to see what is happening with the lesions that they created during the surgery.
So, that's where I am after two months. I'm getting worse and not seeing any improvement. That may be a sign that I will get better, or it may not. I still have a long road ahead of me.
Monday, January 7, 2019
Seven Weeks
Well, today has been seven weeks since I had my Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) to help treat my depression. Except for my psychiatrist noticing a slight decrease in my anxiety, I haven't noticed any change in my depressive symptoms, or in my anxiety. I must say that I am disappointed in the results thus far. I was hoping that I would have noticed something shifting by now. I have to remember, like I keep saying, that it can take three months to a year before any improvement is noticed in the depression of an MRgFUS patient. When every day is a struggle though, three months to a year can seem like a lifetime. Already, the seven weeks that I have been waiting has seemed like a long time to wait.
Today was especially difficult, because it was not only the seven week mark since my surgery, but both of my boys went back to school after the Christmas break. One of them is in university and has been off of school for close to a month, and the other one is in his final year of high school and has been out of school for a couple of weeks. Thus, this was the first day in close to a month that I spent most of the day alone.
Days spent alone are really tough to deal with for someone suffering from depression. The lethargy, hopelessness, worthlessness and loneliness really settle in. As I mentioned in some of my earlier blog posts, I had started to watch a free, online MIT course in economics, to take my mind off of the waiting for surgery to take effect. I finished up that course yesterday, and I must say that it was a struggle. I didn't have difficulty following each lecture on its own, but following 26 straight lectures was a challenge with my diminished intellectual capacity due to my depression. I don't think that I could watch another course. It's just too difficult and I didn't get as much positive benefits from watching a course in a topic in which I am interested as I thought that I would get. Keeping my mind occupied is a real challenge when I have trouble maintaining my concentration, as many people with depression do.
I don't see the neurosurgeon and study psychiatrist that have been following me since before the surgery until three months after the surgery. That should bring me to sometime near the end of February. I really hope that I will notice a change in my mood by that point. It will probably be another five or six weeks before I see them and that just seems like a very long time. I know that in comparison to the close to a decade that I have been dealing with this depression, it isn't long to wait, but when you are waiting for something to happen and trying to deal with all of the difficulties that depression brings, every day is a struggle.
After reading an article recommended to me by a friend, I bought a book this weekend by the author of that article that explores what the author believes to be the root causes of depression and how to deal with them. I don't know if I am going to be able to read that book. Not only do I lack the mental concentration required to read something like that, but I think that I would find reading a book on that topic very stressful. For better or for worse, I am headed down this path to try and get better. I think that reading about the author's opinion on alternative methods of treatment would cause me to second guess myself and lead me into despair. I want to try any method available to get better, I'm just not sure that I am in a good place to try them right now. I don't know. I will have to see if I can get the courage up to read that book.
Thus, I find myself at the seven week mark to be no better off than I was before the surgery. I'm still struggling with the symptoms and trying to find a way to get better, but limited by my own shortcomings. Hopefully things will turn around soon.
Today was especially difficult, because it was not only the seven week mark since my surgery, but both of my boys went back to school after the Christmas break. One of them is in university and has been off of school for close to a month, and the other one is in his final year of high school and has been out of school for a couple of weeks. Thus, this was the first day in close to a month that I spent most of the day alone.
Days spent alone are really tough to deal with for someone suffering from depression. The lethargy, hopelessness, worthlessness and loneliness really settle in. As I mentioned in some of my earlier blog posts, I had started to watch a free, online MIT course in economics, to take my mind off of the waiting for surgery to take effect. I finished up that course yesterday, and I must say that it was a struggle. I didn't have difficulty following each lecture on its own, but following 26 straight lectures was a challenge with my diminished intellectual capacity due to my depression. I don't think that I could watch another course. It's just too difficult and I didn't get as much positive benefits from watching a course in a topic in which I am interested as I thought that I would get. Keeping my mind occupied is a real challenge when I have trouble maintaining my concentration, as many people with depression do.
I don't see the neurosurgeon and study psychiatrist that have been following me since before the surgery until three months after the surgery. That should bring me to sometime near the end of February. I really hope that I will notice a change in my mood by that point. It will probably be another five or six weeks before I see them and that just seems like a very long time. I know that in comparison to the close to a decade that I have been dealing with this depression, it isn't long to wait, but when you are waiting for something to happen and trying to deal with all of the difficulties that depression brings, every day is a struggle.
After reading an article recommended to me by a friend, I bought a book this weekend by the author of that article that explores what the author believes to be the root causes of depression and how to deal with them. I don't know if I am going to be able to read that book. Not only do I lack the mental concentration required to read something like that, but I think that I would find reading a book on that topic very stressful. For better or for worse, I am headed down this path to try and get better. I think that reading about the author's opinion on alternative methods of treatment would cause me to second guess myself and lead me into despair. I want to try any method available to get better, I'm just not sure that I am in a good place to try them right now. I don't know. I will have to see if I can get the courage up to read that book.
Thus, I find myself at the seven week mark to be no better off than I was before the surgery. I'm still struggling with the symptoms and trying to find a way to get better, but limited by my own shortcomings. Hopefully things will turn around soon.
Friday, December 28, 2018
Decrease In Anxiety?
For the most part, on this blog I have been talking about my problems with depression, which have been pretty severe, as I have described. The main reason that I did Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) was to treat my depression. However, associated with my depression has been some fairly severe anxiety as well. I have difficulty leaving the house or doing things on my own because of this anxiety, so, like the depression, it is pretty debilitating as well. My psychiatrist and therapist believe that my depression is the primary condition, with the anxiety being secondary. Hence, the anxiety is only there because of the depression and if the depression went away, so would the anxiety. It is quite common for people with depression to also have anxiety and vice versa.
Well, I had an appointment with my psychiatrist today and he made an observation that was very interesting and may be relevant to the results of my MRgFUS surgery. He observed that I seemed less anxious than normal and just more at ease with myself during the appointment. I have been seeing this psychiatrist for many years, so his observation that I seem less anxious is worth noting.
That, of course, is a very subjective observation and not much to go on, so he gave me a Beck Anxiety Inventory (BAI) test. I received a score of 21. Now, I have done a bit of research today, and there seem to be several different rating scales for the BAI. However, he said that my score was on the high end of low anxiety, which is not inconsistent with the rating scales that I have seen. Of course, we don't have a score for the BAI that was performed before my surgery, so this score alone is not particularly useful either. However, my psychiatrist said that he would never before have considered me to be in the range that I received. Thus, there is evidence that my anxiety has decreased since my surgery.
That is all very interesting, however I haven't noticed any real change in my depression or anxiety myself since the surgery. To me, I still feel just as anxious as I did before the surgery. I still worry a lot and I still have trouble doing things. Thus, I wouldn't take this as strong evidence that something has changed. However, it is something for me to keep in mind over the next little while as I await more concrete results.
Well, I had an appointment with my psychiatrist today and he made an observation that was very interesting and may be relevant to the results of my MRgFUS surgery. He observed that I seemed less anxious than normal and just more at ease with myself during the appointment. I have been seeing this psychiatrist for many years, so his observation that I seem less anxious is worth noting.
That, of course, is a very subjective observation and not much to go on, so he gave me a Beck Anxiety Inventory (BAI) test. I received a score of 21. Now, I have done a bit of research today, and there seem to be several different rating scales for the BAI. However, he said that my score was on the high end of low anxiety, which is not inconsistent with the rating scales that I have seen. Of course, we don't have a score for the BAI that was performed before my surgery, so this score alone is not particularly useful either. However, my psychiatrist said that he would never before have considered me to be in the range that I received. Thus, there is evidence that my anxiety has decreased since my surgery.
That is all very interesting, however I haven't noticed any real change in my depression or anxiety myself since the surgery. To me, I still feel just as anxious as I did before the surgery. I still worry a lot and I still have trouble doing things. Thus, I wouldn't take this as strong evidence that something has changed. However, it is something for me to keep in mind over the next little while as I await more concrete results.
Saturday, December 22, 2018
Christmas With Severe Depression
As I wrote in my last blog post, this past week I had my one month follow-up appointment for the Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) I had for my Treatment Resistant Depression. One of the things that we did at this follow-up appointment was to redo the psychiatric scales that we also did before I had the surgery. This is to determine whether I am starting to improve and my depression is decreasing, or if I am holding steady. As I have mentioned before, they don't expect any changes until three months to a year after the surgery, so to see anything this soon would be remarkable.
As I wrote back when I originally did the psychiatric scales, all of the tests that I did showed that I was suffering from severe depression. There were three tests that I did that measure the level of depression with which I am suffering. The first one was the Hamilton Rating Scale for Depression (HAM-D). Originally, I received a score of 25 on this test. Now my score is 24. Scores of greater than or equal to 23 indicate a very severe depression. Thus, I have scored a slight improvement according to this test. The second test that I did was the Montgomery–Åsberg Depression Rating Scale (MADRS). Originally, I received a score of 36 on this test. Now my score is 38. Scores of greater than 34 indicate severe depression. So, I am getting slightly worse according to this test. Finally I did the Beck Depression Inventory (BDI). Originally, I received a score of 36 on this test. However, now my score is 37. Scores of greater than or equal to 29 indicate severe depression. Thus, I also am getting slightly worse according to this test. Overall, these test scores indicate that I am not improving, but not getting substantially worse, which matches with the way that I have been feeling. Hence, the surgery has had no effect on me as of yet, I am still suffering from severe depression.
This is very discouraging. I know that I am not supposed to feel anything this early on in the process, but I was hopeful that I would start to feel a slight shift at least by Christmas. Christmas is a time of celebration in which we are supposed to get together with and enjoy the company of family and friends. Celebrating Christmas with severe depression is very difficult. It magnifies the negative feelings that you are experiencing, at a time when you have to wear a mask to hide those feelings.
It may just be the Christmas season bringing me down, but I don't feel hopeful about this surgery. I don't feel like it will help me get better. I am concerned that I might have made a mistake in having this surgery. I don't know how I am going to get through the next 11 months if I don't start getting better. The neurosurgeon and psychiatrist that I met with this week were still very hopeful that I will start to feel something within the next few months, but I can't say that I share their optimism. If I had started to feel even a slight shift in my mood, then I could be optimistic, but at this point I am concerned that I will never get better, and that's not a good feeling with which to be going into the Christmas season.
As I wrote back when I originally did the psychiatric scales, all of the tests that I did showed that I was suffering from severe depression. There were three tests that I did that measure the level of depression with which I am suffering. The first one was the Hamilton Rating Scale for Depression (HAM-D). Originally, I received a score of 25 on this test. Now my score is 24. Scores of greater than or equal to 23 indicate a very severe depression. Thus, I have scored a slight improvement according to this test. The second test that I did was the Montgomery–Åsberg Depression Rating Scale (MADRS). Originally, I received a score of 36 on this test. Now my score is 38. Scores of greater than 34 indicate severe depression. So, I am getting slightly worse according to this test. Finally I did the Beck Depression Inventory (BDI). Originally, I received a score of 36 on this test. However, now my score is 37. Scores of greater than or equal to 29 indicate severe depression. Thus, I also am getting slightly worse according to this test. Overall, these test scores indicate that I am not improving, but not getting substantially worse, which matches with the way that I have been feeling. Hence, the surgery has had no effect on me as of yet, I am still suffering from severe depression.
This is very discouraging. I know that I am not supposed to feel anything this early on in the process, but I was hopeful that I would start to feel a slight shift at least by Christmas. Christmas is a time of celebration in which we are supposed to get together with and enjoy the company of family and friends. Celebrating Christmas with severe depression is very difficult. It magnifies the negative feelings that you are experiencing, at a time when you have to wear a mask to hide those feelings.
It may just be the Christmas season bringing me down, but I don't feel hopeful about this surgery. I don't feel like it will help me get better. I am concerned that I might have made a mistake in having this surgery. I don't know how I am going to get through the next 11 months if I don't start getting better. The neurosurgeon and psychiatrist that I met with this week were still very hopeful that I will start to feel something within the next few months, but I can't say that I share their optimism. If I had started to feel even a slight shift in my mood, then I could be optimistic, but at this point I am concerned that I will never get better, and that's not a good feeling with which to be going into the Christmas season.
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