Last week, the FDA cleared Esketamine, a fast-acting antidepressant for people who have severe, treatment-resistant depression. Esketamine is derived from Ketamine, a commonly used reactional drug with psychotropic side effects, though researches as that the Ketamine base in Esketamine is in such low doses that typical side effects seen with Ketamine will be non-existent. However, this landmark decision by the FDA to clear a new antidepressant comes not without barriers. The new drug is costly, more expensive than most would be able to afford, and because of the addictive nature of Ketamine, Esketamine can only be administered and taken in a doctor’s office, hospital, or clinic. It must be inhaled, like a nasal spray, and you have to stay put for two hours after you’ve taken the drug for observation. Additionally, you are also not allowed to drive on the two days a week you’re required to take it.
Doctors will administer Esketamine at the steep cost of $4,720 to $6, 785 per dose, follow up appointments costing between $2,360 to $3,540. Despite the cost being comparable to something like Electroconvulsive Therapy(ECT), Esketamine sounds far less intimidating. It’s worth noting that prior to this approvable by the FDA there have been very few options for people with treatment-resistant depression, aside from years and years of trial and error. Eventually, people with this kind of depression, typically severe and disabling, are left with only extreme measures like ECT or even off label prescriptions for actual Ketamine infusions under the care of a doctor.
But transportation, time, and money are all barrier, while concerns over long term effects remain valid. While doctors aren’t precisely sure which kind of patients would benefit most from a course of Esketamine, the new drug might serve its purpose even further by providing people with depression relief as they wait for traditional antidepressants to do their job. Esketamine could possibly help people who are acutely suicidal and pose a serious risk to themselves or others. Working alongside antidepressant, Esketamine would work as a helping hand, a team member rather than a sole player.
I’ve been fighting chronic health conditions for years.
Every day when I didn’t want to get up I knew I couldn’t give in. But it wasn’t always so easy for me. When the voices started I listened to them. When they told me to hide I hid. When they told me to stay in bed I pulled the pillow back over my head. When they told me that there was a higher power, unnamed though it was, that whispered when the wind blew, I prayed to the wind. When they told me I was a piece of shit I believed them. When they told me my medicine was poison I dumped them down the toilet. I ate when they said I could and didn’t eat when they wouldn’t let me. I counted the patterns in the colors of the cars that drove by me.
When they suggested I kill myself I gave it my best shot.
Now I’m glad I’m here, alive, breathing, thinking, writing and creating. I’m glad to see the sunrise and the wind doesn’t whisper like it used to.
I used to have visual hallucinations. More real than you in front of me. More real because that’s what my brain told me. So real that I felt their breath sometimes, felt their fingers on the back of my neck, saw their eyes move as they watched me. You can’t know what it’s like to hallucinate until you have.
My last visual hallucination was of an alien set upon reading my mind by sticking his fingers in my brain. That was three years ago. My brain’s last attempt at lying to my eyes. Though sometimes it still plays tricks and I see red cats out of the corner of my eye.
But the voices, they never stopped. They’ve been a constant part of my life for about five years now. It’s never quiet. There is never an instant of silence. It sounds like a beehive inside my head. Like a congested subway. Like a too full elevator. It sounds like panic and sadness and mania and anger. Some I can understand and some I can’t. Some sound like a radio in the other room. Some voices sound like voices sound. Some sound like dull hum of white noise. Some come from outside my head and make me turn around, scan the landscape or the crowd. There’s never a source, at least not one other than my own head.
Not to be confused with, “It’s all in your head.” One thing I’ve learned is to never let anyone get away with saying that. As if your brain isn’t part of your body. As if they don’t function as a whole. As if they don’t work together to create absolutely every experience you’ve ever had, every feeling you’ve never felt, every movement you’ve never made, any sound you’ve ever heard, every taste you ever tasted. You cannot have one without the other. The brain and body exist together, one thing that has one goal. When you are sad it’s the whole body that is sad, and when you cry it’s the whole body that cries. It’s the whole body that becomes tired. It’s the whole body which achieves happiness. It’s the whole body which becomes sick. You cannot have the oceans without the moon, or day without night, or spring without winter.
It’s with my entirety that I have Schizoaffective Disorder, it’s my entirety with which I fight. It’s my entirety with which I breathe. This how all things exist. With their entirety.
I’ve learned that my hallucinations are part of me. It’s who I am. Illness is a part of me. But life is a part of me too. Happiness is a part of me. And my body and my brain, they are me.
“It’s not all in my head.”
“It’s all of me.”
You cannot fight a war against yourself. Instead, you’ve got to learn to live with yourself. You’ve got to learn to be gentle with yourself. To let yourself breathe and sleep and wake and you’ve got to move and experience. But that’s all. If you can’t bare anything else today, just exist. Exist from where you are. Life can’t ask anything more from you.
Just exist and tomorrow try and exist a little bit more.
Chronic illness, mental illness, an illness which endures is indescribable. It’s made up of pain which cannot be fully understood without actually experiencing it. People with illnesses and injuries, people like myself, aren’t placated into inaction. It’s not as if we don’t strive for the same things you do. It’s not as if we don’t want to excel. It’s that, to no fault of our own, one day we were thrust into a world inept to meet our challenges. This world wasn’t designed for us. The dreams we once had are dashed when we are told what we won’t ever be able to do again.
After my diagnosis of Schizophrenia, it was a death sentence. I’d never do anything worthwhile for the rest of my life. Called ‘profoundly disabled’. It was suggested that I live in a group home until I might end up in the hospital for a long-term stay. But almost four years later I’ve bought my own house and work part-time. I’m a student about to embark on a four-year program to a masters degree. I’m a published author and advocate for other people with psychotic disorders.
I’ve come so much further than any doctor would’ve dare predict. I am not afraid and in fact, I feel powerful. Like I have power over myself and a mind which doesn’t have my best interest at heart. Battles waged against ourselves are often the scariest. And certainly, they are the most difficult. But, when we face ourselves we experience a transformative journey. One which spurs us onward to wellness. That journey wasn’t easy for me and at times I lost myself. Those closest to me, those who were with me at my worst, know that at times I came close to losing the light. But I’m here now and ready to help those who find themselves on the edge like I once did. People with Schizophrenia are told there is no recovery. But I beg to differ. Hard work, harder work than you’ve ever done before, determination, and support dictates your own journey. Everybody’s recovery may look different in the end. But what’s most important is that you didn’t give up. Even when your symptoms were at their worst. And that you pushed yourself as hard as you possibly could.
The message here isn’t just, “don’t give up!” It’s, “recovery is possible, don’t lose hope.”