New Shrink with a Big Head

Lajp,

Congrats on your Kappa District position. I am glad things have been going well for you. As for the doctor, was he the one who performed the treatment? I bet not. I hate to be a cynic, but a lot of p-docs that don’t offer TMS speak of it in negative terms because it’s their competition. Most of these doctors are myopic morons. They have their depression playbook and if you don’t respond to the treatments in their playbook, you’re sh!t out of luck. If you’re not comfortable with this guy or find him to be arrogant and condescending, it’s time to more on to another doctor. Don’t waste another hour with him. My wife has wasted years of her life on doctors that had no answers for her, but lots of useless prescriptions that gave her lots of side effects and no benefit—some made her so much worse than just the depression alone.

On the bright side, there are good p-docs out there, but you need to really look into them. Unfortunately, the good ones never seem to take insurance. 🙁 As for rTMS, my wife is on treatment 31 today and I don’t really think it’s done that much to help her–but it might be too soon to tell. In clinical practice, the results are very good and they do last a long time. I have never heard of it lasting only a month. If it made you feel better, than it should last for months or years. If you start to back slip, you just go in for four or five treatments to get topped off. Once a responder, always a responder. It sounds to me like you’re new p-doc is a moron (my wife and I have had more than our fair share of those).

In any case, TMS, ketamine, SSRI’s etc.—can only work effectively, if you have all the raw materials necessary to have healthy brain function. It should come as no surprise that most people that are treatment resistant are missing something necessary to allow these treatments to help them. My wife didn’t have a particularly strong respond to ketamine or any other treatment. Even the TMS hasn’t seemed to do much for her yet (she’s getting her 31st treatment today). Fortunately, her p-doc was smart enough to give her a genetic test and blood tests (covered by insurance), which revealed to us that she had a genetic issue with her MTHFR gene that severely blocks her ability to process folic acid and turn it into L-Methylfolate. This blockage means prevents her body from making neurotransmitters, including dopamine and serotonin. You can give all the SSRI’s and other treatments in the world, but if her body lacks the building blocks to make those neurotransmitter, no treatment would help. It’s like getting all the materials to build a house, but you don’t have a hammer and saw. This same MTHFR genetic issue is believed to affect more than 70% of people that are treatment resistant–although the degree it impacts them varies in severity for each person. There is a protocol of supplements that you can order from Amazon (or get as a prescription from your p-doc [although this is expensive and unnecessary[), that will a allow people with this issue to bypass this blockage. I strongly suggest anyone reading this google MTHFR and treatment resistant depression. Here’s one good article on the issue: https://www.psychologytoday.com/us/blog/evolutionary-psychiatry/201607/methylfolate-and-resistant-depression I can’t believe we have been fighting this battle for so long and we never knew about this problem. It should have been so obvious!!!!

So, in the past two weeks, my wife has been taking these supplements and it’s been a bit crazy since she’s now getting flooded with neurotransmitters for the first time in her life (which can be overwhelming), but it’s actually now allowing her SSRI and TMS to start actually helping. So, I expect that once we get through what’s called the “healing crisis” phase (when you feel like crap before you feel better), this is going to work out. I only wish we had known about this years ago—but again, so many p-docs are stuck with their old playbook that they don’t think about any solution to help patients that don’t involve write a prescription of some drug promoted by a cute 27 year old big pharma rep that took them out to dinner a few times.

Anyway, I wish you the very best of luck and don’t let this idiot doctor get you down.

–Eric