A new patient came in this week, referred by a trusted therapist. She had been sexually abused at approximately age 7. She was depressed.

She was on a combination of an antidepressant and a sleeping pill. It seemed to work as well an anything would. The medications were the same kind of medications that I would generally use. Older, reliable, out of patent (more than 7 years old) and thus available in cheap generics.

When I asked her how much of her depression it had made go away, she said “50%.” I ordered my usual list of blood tests. They seemed exotic to her.

We couldn’t even tell if they were things she got ordered in her “annual physical.” She had some kind of blood tests done a month ago. She was reluctant to have more drawn, so I told her we could get the old ones. She looked relieved.

?Relieved?
She was visibly overweight. She had paid a well-known diet center to follow their plan. She had gotten down to her “target weight,” then gone on to gain back most of what she had lost.

She was plagued by seborrheic dematitis. This is not usually a difficult thing to control. She could cut her hair (which went down past her shoulders). She could wash it daily with the prescription shampoo that her primary doctor had (correctly) prescribed. She could wear a little cap, perhaps like the sequiny little one that I showed her I had worn that day.

It was plain to see on her face that I was frustrating her, I just seemed to have more solutions than she had problems.

She asked me if she could return for her next appointment in a month.

She was not suicidal.

I made it clear that if I waited one month I would not increase her medication, for she would have to stay on the same if I were to wait so long until seeing her.

She didn’t mind.

She was not alone among my patients to feel as she felt. I have always failed to understand patients such as she.

Her previous psychiatrist and her previous therapist, had dragged her along for approximately two years.

She had contributed to paying their living expenses, with her fees. Maybe they had improved her status some. I mean, to be fair, I had not seen what she had been like when she started.

Depression is common. Far and away the most common of psychiatric illness, no matter what measurements or statistics you believe.

There are aspects of it that clinical trials of medication have shown, time and time again, get better. Things like sleep, appetite, mood, concentration.

Enjoying life, living your dreams, and such do NOT respond to medication.

Having the desire to correct things than annoy you and make your life better; that is somewhere between spirituality and magic for many of my wide-eyed depressed patients.

Sometimes I am angry at my colleagues. They seem to have accepted the limitations put upon them by government and insurance and economics.

This does not much help the patient.

It takes more than a couple minutes in my office to pump up these things.

I have said “stay tuned” before, but now I must try to bring this message to more media.

Science exists, and ought to be serving humankind.

Stay tuned.