For Sam, living with treatment-resistant depression is like living under a weight that he constantly carries around. For eight years, Sam, a soft-spoken 20-something college student, tried to improve the symptoms of his major depressive disorder that make him feel exhausted and, at times, even ready to take his own life. He has tried 20 different medications. He has participated in therapy and met regularly with his primary care doctor.
More recently, Sam’s symptoms started to overwhelm him. That’s when his primary psychiatrist directed him to Sheppard Pratt.
Treatment Highs and Lows
“My depression had really taken over a huge part of my life,” says Sam. “I had to take a break from school because I couldn’t keep up with the work. Everything, from interacting with friends and family to daily life activities, was a struggle.”
Sam tried to find medications that would alleviate some of his depressive symptoms. Unfortunately, as is true for many individuals with treatment-resistant depression, medication and therapy continued to have little effect. Eventually, Sheppard Pratt’s specialists treated Sam with electroconvulsive therapy (ECT). With ECT, specific areas of the brain are stimulated using brief, controlled pulses. The treatment is administered under general anesthesia and changes the brain’s chemistry to help reverse the symptoms of severe psychiatric conditions. For Sam, ECT provided improvements initially, but then seemed to decline in its effectiveness.
“Sam had a good response to ECT but was beginning to reach a plateau,” explains his mother, Jennifer. “He felt like, ‘here’s another thing that’s not working.’”
Sam wrestled with that feeling of defeat prior to an ECT treatment. Thankfully he shared his feelings with his provider, and he and his care team decided he should go to Sheppard Pratt’s Psychiatric Urgent Care, located just down the hall on the Towson Campus. Once there, Sam was assessed about his depression and his mindset, then admitted to the inpatient unit.
It was during his stay at Sheppard Pratt that Sam really started to find hope as he realized he was not alone and that there were still options for him.
“It helped me just being around people who felt similar to me, who were also in the worst place emotionally that they’d ever been,” recalls Sam. “It helped me to know that I wasn’t alone and that there are people working really hard to help me, even though my depression is treatment-resistant.”
Sam was also encouraged by the progress of his fellow patients at Sheppard Pratt.
“Every day, our group therapist had us rate on a scale of one to 10 how we were feeling,” Sam says. “Some people who started the week at a one or two said they felt like a 10 after just one week!”
Though Sam’s progress continues to be slow, he and his family are encouraged.
“Before Sam was introduced to the services at Sheppard Pratt, he was at the limit to what services he could get,” says Jennifer. “He was feeling like there were no options left for him. Being exposed to doctors who have treated patients like Sam with complicated cases helped us see that we had options and that a higher level of support was available.”
Lifting the Weight
Today, Sam continues to struggle with symptoms of depression. However, he is hopeful that there are still options for him. Recently, Sam underwent the implantation of a vagus nerve stimulator (VNS), a small implanted device that sends mild pulses of electrical energy to stimulate the vagus nerve, which lessens the symptoms of chronic and recurring depression.
Sam and Jennifer are outspoken about the importance of getting quality care for psychiatric illness.
“It’s very hard for me to hear Sam talk about his depression because it’s the hardest thing in our lives right now,” says Jennifer. “But I’m glad he talks about it! When we talked to other people who experience depression to the same severity that he does, it helped us realize we were not alone. Sam also realized that this isn’t a problem with him. It is an illness, and there are options available to him. That was a really important step to help us move forward. I wish we had known sooner about Sheppard Pratt’s specialized care.”
Today, Sam has reenrolled at his university and once again lives independently with his college roommates.
“Before I came to Sheppard Pratt, I felt completely helpless,” he says. “Sheppard Pratt helped me realize that there are options for me. Before, I felt like the only option for me was to take my own life. But now, I have hope. Depression is something that people struggle with silently. That’s one of the hardest parts about it. My time at Sheppard Pratt meant that I could lift that weight and I didn’t have to struggle alone anymore. That’s all I could ask for.”