OK, you probably read that subject line and had one of a few reactions:
1. Fuck all the way off, woman.
2. WTF?
3. Easy for you to say, you privileged white woman.
And honestly, all of those are fair reactions! (All feelings are fair, itās just what we do with them, of course.)
But hear me out?
The basis for this statement is an article I recently wrote for Verywell Mind that I wanted to share here.
āItās a time of hope for many people who havenāt been helped by current treatments,ā says Jeffrey Borenstein, MD, who serves as President & CEO of the Brain & Behavior Research Foundation, which funds mental health research grants.
Thereās a few major classes of antidepressants currently: SSRIs (most commonly known), tricyclic antidepressants (TCAs) and Monoamine oxidase inhibitors (MAOIs.) SSRIs were developed in the 80s, TCAs in the 50s, and MAOIs in the 60s. This is to sayāinnovation in depression treatment has been long overdue.
Especially since many of those medication take weeks to start working fully (though they are generally doing *something* before then, itās not like a switch is all of a sudden flipped in your brain at six weeks) and many of them come with side effects. For example, you canāt have cheese on MAOIs because of the danger of a hypertensive crisis (basically, to my non-doctor understanding: a high blood pressure spike that can lead to a heart attack or stroke.)
Things like Transcranial Magnetic Stimulation (aka TMSāwhich involves small magnetic pulses to your brain) and ketamine work much faster, and a promising study was released this week that said JUST ONE DOSE of psilocybin can help a major depressive episode. Another study is coming as a follow-up to that one that is Phase 3, one of the last phases before FDA approval.
A new antidepressant was recently approved that is a combination of DXM (technically the active ingredient in Robitussin?!) and bupropion (Wellbutrin) and works within a week. Without getting super nerdy, DXM works on the same system in your brain as ketamine. To be honest, I am personally super excited about this tooāIāve been on Wellbutrin for a long time, and ketamine has worked really well for me, so Iām really curious about possibly switching to this.
My psychiatrist is at this neuroscience conference this week, and Iām excited to follow along the updates on twitter.
So, if youāve been dealing with depression thatās not responding well to SSRIs and/or typical treatment, it really is a āgoodā time to be depressedāthereās a lot more options currently and in the pipeline. (Another piece I wrote recently on coping with treatment-resistant depression.)
(And yes, the whole system is indeed fucked, and I know that access remains a major problemāwho cares what the developments are if you canāt access them and/or if your depression is *because* of the effect of many of these structural inequalities on your life?)
My plan for this newsletter is to have both more informative pieces like this one as well as more personal onesāwith maybe the personal ones/some of the personal ones behind a paywall.
I get a lot of questions about ketamine treatment and my experience with it , and so Iām definitely planning on writing a newsletter piece about that, so please reply to this if you have specific questions about ketamine. (Or anything else youād like me to write about here! I am planning on a magnum opus on how to find a therapist, for one.)