The End of the Journey?

 Well the day has come for me to end my Spravato journey.  Or at least it appears that way.  I am at least closing this chapter of it. This is not by my choice but by the clinic’s choice as they called me last week to notify me that they would no longer be open on Mondays which are the only days I can receive treatment due to my job.  And even those days are difficult for me. 

In all honesty I was only staying on as a crutch of sorts.  I hit remission at month 9 but I felt it was important to continue for monthly maintenance because I was worried about slipping out of remission.  That is why it is called remission and not CURE.  I have been in remission before and it was amazing.  I was able to accomplish so much in terms of my life like losing weight.  Now I also know how hard and quickly you can slip out of remission and I am afraid there will be nothing there to catch me. 

Once you stop, your insurance approval wanes and your need to restart protocol increases.  I cannot sacrifice that level of time again.  Protocol was difficult to get rides and to navigate days with my job to do it.  So I decided to do monthly maintenance for as long as I could, maintenance that would hold the line so to speak. I knew there could come a time when I would either be physically unable to get there or my insurance would shut me down.  I also had to limit the Mondays I was even available due to some changes in my work schedule and having to “stay over” between weeks so I was already having to juggle with maybe 1 week a month that I was actually home and able to go. But I did not see the clinic closing on Mondays as a reality in that juggling or planning. 

When I was initially notified of this I, of course, was in shock and demanded all my future appointments be cancelled (which were all on Mondays) and then also that they cancel my appointment with my psychiatrist (effectively severing my connection with the clinic completely).  It was very knee jerk of me and I am sure they knew that.  They started to tell me I could just let them know when I had another day available.  No matter how many times or ways I tried to explain my work situation and my ride situation (as Mondays are the days Jym has off to drive me there), they kept pushing back until I just stopped replying. 

Days later, after me NOT rescheduling, the Spravato rep contacted me and after explaining in detail why I could ONLY do Mondays he said he would try to find me another clinic in my area (which there are none) so I have not heard back from him as expected. 

I still had the appointment next month on the calendar with my psychiatrist (who is associated with the clinic and is the way I get the Spravato prescribed) and was unsure what to do about it.  I usually react out of anger but this time I just held with it and waited until I could get the opinion of someone else, or I calmed down enough to make a rational decision.

Friday I had a session with my EMDR therapist and I told her what was happening because it was weighing on me so greatly that I was unable to work on what I was there to work on with her.  She recommended that I keep the appointment so that I can discuss this with the psychiatrist and find out exactly what my options are moving forward.  I also have my insurance approval at stake because it expires in May and it was time to re-up it. 

She said that this is a very delicate time to just cold turkey quit it.  If that is what has to happen then I need support on the back end.  But right now, especially with the state of the world, it is a lot on my brain.  I am also digging in deep to this EMDR therapy and the use of the Spravato in conjunction with it was a benefit.  It helps me really get in deep and confront what I need to. So I am at least keeping my appointment and moving forward from there.  I am sure I will update when decisions are made.  I am truly uncertain of what options I even have at this point.  But this way, the choice will be MINE and NOT theirs. 

As far as my mental state with this, I don’t know what to say.  I feel kicked out and that I was unable to make this choice for myself.  I also feel like maybe I would never be in a place to make this decision for myself.  Not that I am addicted.  I don’t mean it to sound that way.  But that I felt it was something I was doing in these hard times to keep myself mentally healthy and whether that is true or not, it was true in my head.  It was my 2 hours a month of self care.  2 hours when I could focus on healing.  I feel like the rug was yanked out from under me.  Maybe that is how my whole life has been.  The comparison is uncanny.  I never walk away.  I cling onto things, things that are good for me and things that are bad for me.  I don’t walk away.  I don’t know why I am this way but I am working to find out why and fix that so I CAN walk away from things.  But maybe this is not the thing I should test that on right now. 

I guess I always assumed I would wait until I felt either the benefits were no longer outweighing the cost to go, or I felt emotionally stable enough to try without, or I had a plan in place for the future of my remission.  None of those were true yet.  But now I am forced to at least work on making sure things are in place for the future of my remission at the very least.  And I will accomplish that in part, with the psychiatrist apt in April.  Until then I can use the time to consider my path forward without it. 

Right now I am stable as far as the depression and SI goes.  I am doing well.  I am on track.  Am I sad and anxiety ridden over what is happening in the country right now.  Hell yes.  Do I cry and feel stressed out.  Yes.  But that is NOT to be confused with clinical depression or SI.  It is different.  And I am in remission right now.  I feel that.  I know that.  I would like it to stay that way.  Because I also recognize that you are only ever one bottle of pills away from suicide if you aren’t.  I do not intend to let my guard down and miss the signs I am headed back in that direction.  I am very mentally aware.  I know very well the sensation of being dragged back to that place.  I also know that the EMDR therapy I have committed to is going to be a hard path thru my worst demons.  It is not a place you want to go raw and without some armor.  Spravato was my armor in this time.  Whether I need it in the moment or not. 

I do know that maintenance is a personal choice and not one that everyone makes.  Some people quit when they hit remission and just roll with it.  But I did not feel I was in a place to do that in my own personal situation. 

I think adding to this loss or change or whatever you want to call it, is that I have also lost my support system.  The disconnection of this post pandemic world has been a challenge for me and I have relied very heavily on Jym to be the support that I used to get from a lot of places and a lot of people.  But I am away from him a lot with work and although I am trying to build a support system there, it is a work in progress.  It is hard for me to trust and to build those relationships quickly.  I am someone who spends years learning to trust and opening up to people so when I started to lose the support system I had LONG cultivated it was hard to even consider rebuilding it.  But now that I am free of the fog of depression, thanks to Spravato, I can finally start to work on that and to rebuild what was lost. Admittedly I am still slow at it, but it is happening.  I am allowing people inside again.  It will just take a while to get there.

So that is where I am.  I knew I needed to at least update the blog and honor myself and the commitment I made to myself to chronicle my journey in its entirety, even the bad things.  So I will have the next month til my psychiatrist appointment to really consider what is acceptable to me and what is not and shifting my focus to my EMDR therapy.  Maybe this journey is over for me.  Maybe I have gotten what I needed to and I am just a little bird being kicked out of the nest so I can fly.  Time will tell.  But I hope I can find a path ahead that respects the work I did to get here and gives me some peace of mind and doesn’t just leave me angry and helpless.  Goals.