Getting Medical Care for Depression is a Cakewalk

Never won anything there, either

I’ve been to a few church bazaars, a 4H carnival or two and a number of school picnics.  And over the years I’ve had the opportunity to participate in a lot of cakewalks.  If you’re unfamiliar with what a Cakewalk is, it’s a bit like musical chairs without the pushing and shoving at the end.  Typically, numbered discs are placed on the floor in a circle.  For the price of one ticket you can stand on a circle and as the music is playing step from one circle to another.  Once the music stops you stop on the circle you’re on and a number is drawn in some fashion.  The person standing on that circle wins their choice of a cake from the homemade goodies on a table nearby.  Playing again costs another ticket.  Although you wouldn’t know it by looking at me, I’ve never won even once at this game of chance.  That’s why I’ve never understood the old cliché.

If something is referred to as a “cakewalk” it implies it’s easy.  Call me unlucky (because I typically am) but cakewalks are no cakewalk for me.  True, I suppose little effort is needed, I mean all you have to do is walk in a circle and make sure you can advance to the next numbered circle.  (I’ve seen the uninformed get caught between circles once the music stops, reducing their chances of winning to zero)  In addition, the cost of admission to the game is often very low, something around $.50 to $1 and the reward is high.  Who wouldn’t want to take home some home-baked sweets?  However, the fact of the matter is, for those of us unlucky types, winning in this endeavor is not easy.  Turns out, trying to medically treat depression, at least for me, is another cakewalk.

I’ve been trying one thing or another to combat depression for over 30 years and as much as I’ve learned about myself over that time, enlisting the help of healthcare professionals is just as much of a crapshoot.  Please don’t get me wrong this is not an indictment of the healthcare profession.  Nearly all of the doctors I’ve consulted and worked with over the years have been well-meaning, caring individuals.  Not all, but most, have attempted to get to the bottom of my depression, diagnose it and treat it effectively.  However, the “practice” part of the term “practicing medicine” is really never more on display than when trying to treat depression.  And why wouldn’t it be?

After a long series of questions about everything from what happened to you when you were a child to how well you slept last night, what can only fairly be titled a “tentative” diagnosis is reached.  The next step is usually to advise counseling and medication.  Counseling can usually happen fairly quickly.  Meds are another story.  The beginning dose is usually low for the safety of the patient because as effective as these things are in treating depression, they can also have just the reverse effect.  I know, I’ve read the labels.  Gradually the dosage is increased to the recommended level assuming no effect is felt immediately.  The rule of thumb for this to play out?  Six weeks.

Six weeks to find out if this best guess will take.  For those of you out there that have suffered and struggled with depression I don’t have to tell you how long six weeks feels like.  For those of you that haven’t, imagine that four weeks ago you woke up to find your thumb in a vise.  Over the course of the next few weeks the vise got tighter and tighter until you couldn’t stand it.  Finally you go to the doctor and say, “I gotta get this vise off my thumb, it’s killin’ me!”  Your doctor asks you a battery of questions.  Has this ever happened before?  When?  Did it take this long to get unbearable?  What have you tried to do to remove the vise?  Did that help even a little?  Finally after all the questioning the doctor gives you a prescription and tells you, “Take one pill the first week and two pills the second and check back with me in six weeks.”  When you ask if the medicine might work sooner they say, “It could, but standard effectiveness is six weeks.”   Six weeks later you’re back at the doctor’s office.  Your meds didn’t help.  The whole process was a cakewalk.  A cakewalk through your brain except we’re not talking about Mrs. Johnson’s Pound cake or Aunt Betty’s Strawberry shortcake.

Trying to arrive at the right medicine brings up all sorts of discussion about unseen, unknown, things like serotonin, dopamine, norepinephrine and acetylcholine.  These can all be affected not only by your state of mind but by traumatic events in your life, your overall health, age and basically anything having an effect on you.  I once got depressed by a really bad salad.  (I’m kidding, I didn’t, but sometimes the condition seems to make as much sense)  It’s no wonder the whole process can be so difficult and at a time when you’re least equipped to handle difficulty.  So how do you soldier on through this muck?  Easy, lower your expectations.

The fact of the matter is you may have to pay multiple tickets.  You may have to listen to the music stop many times only to watch some cheeky kid walk off with his Bundt cake when you’re not on the chosen circle.  The only thing to do, assuming you want to continue to play, is ante up again and go around and around.  The whole process can be disheartening but at present it’s all we have.

So I’ll pay another ticket.  The fact is, I don’t have much choice.  Start the music.  I have my eye on that cheesecake over there.

I’m currently going around in circles in hopes of baked goods again.  Honestly I turned back to the docs because I was flat out tired of circling around with my own, usual tactics and remedies having no effect.  Maybe we’ll get it right this time.

I write about lots of cheerier subjects than depression.  Really, I do and I can prove it.  Click here to go to my blog and find out.  Assuming you like what I write I hope you’ll want to keep reading.  The easiest way to do that is to subscribe to the blog.  It’s free and means you will get an email weekly with links to my posts, nothing more or less.  To subscribe, click this.

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