The Assessment (part 2)

…continued from “The Assessment (Part 1)….

I wait some more in the bare room, painted with some odd, hospital green color up to the chair rail (or some sort of padded rail), and then cream for the rest. I don’t know why they bothered with the wallpaper border that was placed near the ceiling.

Dr. F finally walks in. I stand up, and we politely introduce ourselves to each other. I had been told by Dr. A that he was in his 70s, but his age is not apparent at all from his looks. I don’t know what I expected – perhaps nothing at all – but he’s only somewhat taller than I am, and he has on a tie and a jacket, no white coat.

It starts on an awkward note. “So, you had ECT three years ago,” says Dr. F. “No, it ended in late February,” I tell him. Instead of the dates of my outpatient ECT, he had been given a chart that had my last hospitalization date, which had been three years ago. I guess he hadn’t read my file. He asks me a little more about how long I had been out of ECT, if I thought it helped, and when the depression came back. I think the depression came back about two months ago, I reply, and to that, he notes to me, “so the effects only lasted for two months.” I hadn’t really done the math until then. I put my hands over my month to say to myself, “That was it? Two months?”  Fifteen treatments to have only two months of ceasefire of some sort? It is at this point when my mind begins to wonder if I am really making the right call.

The evaluation goes on. Dr. F mostly asks me questions that were similar to the ones asked by the assessment person. At one point, he does say to me that I don’t look depressed. I end up having to explain that I never come across as a depressed person. This is one of those comments I probably should’ve expected. The thing is, if I’m outside of my home, I try to look fine. And most will agree that they’d never know I have some mental disorder just from looking at me. But I become almost uncomfortable with that comment because I’m generally afraid people are skeptical to the nature of the illness or can’t really see beyond my exterior. Now I’m afraid that Dr. F’s initial perception of me from the exterior has skewed this assessment. I now question to myself if the indifference I feel is just part of being human or if it’s even depression. I lose confidence in the answers that I have about my own self, because I can’t tell if I am right about how I’ve viewed and felt the last month or so. Have I painted an inaccurate picture of my very self? Am I labeling certain behaviors as “symptoms” when they’re just me being me?

I get through the questions somehow, and Dr. F begins to talk about the treatment itself. As he talked, it dawns on me that he is expecting for me to have ECT once-a-week for at least the next few weeks, and then tapered very gradually to twice-a-month, etc. Though Dr. A and I’ve discussed the idea of maintenance ECT, as in having it once-a-month or so, we’ve been focused on just this single treatment. One Treatment only. He explains to me that this is how a tapering schedule works and that this is probably what Dr. A had in mind. I am not sure what to say. All I could do is nod while looking shocked and confused. I do manage to get across to Dr. F that I hadn’t expected to hear what he had just said.

By the end, I am caught totally off-guard. He wraps up the evaluation with some remaining questions. He tells me those are all the questions he had for me, gets up, shakes my hand and leaves.

I tug on my hair hard as I walk out the hospital door and to my car. Later in the afternoon I am home, and I google about this ‘tapering schedule’ that Dr. F had talked about. In all my readings that I had done, I must have missed reading more carefully about maintenance ECT, because the procedure he talked about is so clearly written out in the clinician books and ECT program web sites. How could I have totally missed reading all this info?

I now am not sure about a thing.


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