Several months before deciding to try ketamine infusions I had genetic testing intended to identify which treatments might be more effective for me than others. The expensive tests were only partly covered by insurance and it is still unclear to me, six months later, whether I may have to pay a balance of over a thousand dollars.
The results said that SSRIs would not be effective, and that I’d be prone to gaining a lot of weight on drugs like Abilify. Believe me, I already knew both those things!
But the genetic testing helped me quiet the self-doubts I’d internalized over years of interacting with people who see patients with treatment-resistant disorders as if we’re somehow choosing to be “difficult.” Like it was my fault that I had a seizure on Wellbutrin, that over time the MAOIs stopped working, that ECT caused so much cognitive impairment, and that so many other treatment attempts didn’t help. A few psychiatrists described my treatment-resistance in terms of “personality issues”. Though childhood emotional abuse and prolonged illness can certainly influence one’s personality, what these doctors were saying is code for something much worse. That I’m the type of patient who frustrates them by not getting better; the type they don’t like to bother with or take seriously.
The effectiveness of the ketamine infusions, combined with the results of the genetic testing, make it perfectly clear to me that the medications I was being given didn’t work because they genuinely weren’t right for me — NOT because I chose (consciously or unconsciously) to make things difficult! The doctor who provides my infusions even reassured me that most of his patients for whom ketamine makes a big difference have complicated histories (including abuse and multiple disorders and so on). It mattered a lot to me that for once the varieties of pain I’ve lived through weren’t being seen as another strike against me.
Hopefully you don’t need to pay for genetic testing to learn this lesson: If you’ve been giving your prescribed treatments a solid chance and they’re still not working, don’t blame yourself or give up hoping for something better. None of us deserves that.