Ain't No Magic Wand

Today we’re going to be talking about a tricky subject, so I’m going to tread lightly.

Our clinic prides itself on not only giving hope to folks with treatment-resistant depression, anxiety, and PTSD, but also by providing innovative treatment solutions that aren’t widely available anywhere else like ketamine infusions and PrTMS, which I have discussed in previous podcasts.

While these outside-of-the-box treatment options are fabulous, and tend to work much more quickly than traditional treatment options, they are but a tool in your healing tool belt. Nothing that we offer is a panacea or cure-all by any stretch of the imagination. Nothing is. Typically approaching a problem like treatment-resistant depression, for instance, requires a multifaceted solution.

To be able to treat the whole individual, we like to look at all the different aspects of the person’s life:

1. What type of sleep are they getting? Do they snore or need a sleep study to rule out apnea? If you are not breathing for long periods of time, you are depriving your brain not only of oxygen, but also of the restorative rest it needs to clean up your brain!

2. What type of diet do they partake in (and this means so much more than nutrition! Your diet includes what you put into your body as well as view and listen to! If you’re listening to hate speech and death metal all day, you’re far more likely to road rage, for instance!). I am suspicious of any eating plan that completely cuts out a food group because your brain needs protein, carbs, and fats in order to survive. So if you are cycling on and off fad diets in order to lose weight quickly, this can also drastically affect your mood.

3. Are there outside influences that are negatively impacting your mental health?

1. These could be using drugs or excessive alcohol intake

2. These could be stressful interactions or pressures at work or home

3. Relationship issues with friends, intimate partners, spouses, or coworkers?

4. Death or illness of a close friend or family member

5. Has there been a recent move?

6. Have they been checked for a low thyroid, anemia, or low hormones, as all of these could mimic depressive illness!

4. Are they getting enough exercise and sunlight?

5. Are they getting enough social interactions? Or are they isolating, resorting to only home and work?

6. Are they currently on medications? Tried and failed a number of medications? Or getting a lot of side effects on their mediations?

7. Do they have other serious medical illnesses that take their emotional toll with frequent doctor and hospital visits? Or are they in chronic pain from inflammatory or orthopaedic issues? Have they had multiple concussions or head injuries from playing in contact sports or multiple motor vehicle accidents?

8. Are they participating in talk therapy?

9. Are they journaling or meditating?

10. Are they getting enough hydration? Your neurons are essentially made of fat and water. IF you are in a chronic state of dehydration like most of us are (as I sit here sipping my Starbucks froofie drink), then your enzymes are less able to metabolize things properly, including neurotransmitters! Enzymes are finicky little critters that like things a certain way. If you are dehydrated and there’s not enough water around, then your body temperature is slightly elevated and not within their finicky required range to produce a neurochemical reaction. So believe it or not, not drinking enough water can slow down your brain as well as your body! The ultimate goal would be to slowly aim for drinking approximately 1/2 your body weight in ounces.

There are a multitude of factors that can contribute to a diagnosis like treatment-resistant depression. You may have been dealt a crappy genetic hand. You may have had multiple losses and feel very socially isolated, maybe cut off from the world or emotionally alone and struggle to believe anyone has had experiences like you do (many people have, by the way, but you would never know it if you only paid attention to the highlight reels on Facebook and Instagram…AND people rarely talk about such things unless they are in therapy or you ask directly.) You may have so many medical illnesses it’s hard to pick yourself up out of bed and get yourself going day to day.

While all of these issues can precipitate mental illnesses, or even worsen what may already be there, YOU also have a responsibility to yourself for participating in your own treatment.

For instance, if you had a friend or family member try a medication that had an adverse effect and your doctor suggests you try it, you will obviously have a negative psychological association with it. TELL YOUR DOCTOR. Contrary to popular belief, they cannot read your mind. They need to know and understand that this may not be the med for you. You have to advocate for yourself in these circumstances. You are there to partner with your prescriber, not be dictated to. You have a right to know and understand what goes into your body. And if you don’t have a good enough understanding of the usage or side effects of a particular drug, you have the right to ask to be educated, or even refuse it.

Another example of this: exercise is the best possible “antidepressant” that we could ever prescribe, and yet, almost none of the patients we see are participating in it! Even if you aren’t using it for weight loss or to rehab an orthopaedic injury, 30 minutes of exercise alone, daily, can increase your brain’s cortical thickness. Translated, the thinking part of your brain, or the grey matter, increases when you exercise! It also increases the production and circulation of BDNF, or brain-derived neurotrophic growth factor, which is essentially miracle grow for your brain! Do you want to keep your brain young and postpone dementing illnesses like Alzheimer’s indefinitely? Daily exercise. Even if it’s just walking the dog around the block. You may never “feel” like doing it, but it’s something you’ll always be glad you did, and sometimes you have to press yourself out of your comfort zone for growth and healing to occur. Alternatively, if you are over-exercising, you may also be over-producing cortisol, the stress hormone, which can not only negatively impact your bones and make you more prone to stress fractures, but also decrease your immune system’s ability to fight off bacterial and viral illnesses! If you’re not getting ENOUGH nutrition on top of that, or exercising enough to cause a severe caloric deficit, then you also may be sacrificing muscle cells, cardiac cells, and even neurons if you’ve been in starvation mode long enough.

Are you sleeping properly? Do you get enough sleep? Are your days and nights flipped? Are you on swing shift? Are you snoring or waking up excessively? Do you wake your spouse up at night tossing and turning? You may need to consult with a sleep doctor to rule out sleep apnea. Do you have trouble getting to sleep or staying asleep? Maybe you need to lock the dog out of the bedroom. Maybe you need to not watch John Wick right before bed. It’s important to have good sleep hygiene, or at least the best you possibly can. Avoid anything with a blue light 2 hours prior to bedtime. Set an alarm and start shutting off electronics before bed as you’re winding down. Read a book with physical paper pages you can turn. Take a relaxing bath. Don’t drink heavily or overeat or eat super spicy food right before bed. Turn the thermostat down 3 degrees, keep a journal beside your bed. Keeping a proper sleep/wake cycle is key to hormonal balance and keeping your Circadian rhythm in check. Every morning between 6 and 10am, you need blue light to hit your retinas without glasses, contacts, or windows being a barrier. IF you can’t get direct sunlight, then opt for a “happy light” or lamp you can purchase off Amazon for like 30 bucks. Just make sure to get one that has at least 10,000 lux which is a measurement of light. Those are the ones at that level that can improve seasonal affective disorder and depression medically.

Also, in regards to sleep, the number of sleeping agents, sedatives, hypnotics, and benzodiazepines prescribed for sleep has radically increased. While these may GET you to sleep, they certainly don’t provide restorative sleep and likely decrease your ability to get into and stay into REM, as does alcohol and THC. So they may “knock you out” but you certainly won’t feel better in the morning.

Has there been an unresolved issue with your spouse or loved one for some time that you’ve both been avoiding? This can sap emotional energy like a slow-leaking balloon. If it’s not something you feel you can address on your own, it’s important to seek out therapy from a trusted clinician who can help mediate your problems with a more diplomatic and neutral point of view.

Have bills been piling up lately and you’re wanting to bury your head in the sand to avoid thinking about your finances? Work with someone to sketch out a budget to help you make sure you can climb your way out of debt. It can take a tremendous load of stress off your shoulders to know you’re making forward momentum, albeit slowly, towards your goal of being debt-free.

So when you’ve only taken a medication for 2 days, or you’ve only been in therapy for a week, or have had a single ketamine infusion or PrTMS treatment and you don’t feel instantaneously better, THERE MAY BE SEVERAL REASONS FOR THAT. First of all, you may have not given your treatment enough time for things to feel better. Or there may be too many life stressors, not limited to the ones we just spoke about, to be immediately “fixed.” And none of these treatment options “FIX” your life. You still have to do the work of that. I know, probably not what you want to hear. There are several patients who are desperate to feel better by the time they reach our doors, who have literally tried everything available outside of what we offer. And like every other human I know, they want to feel better NOW. They’ve been suffering for far too long. They want a special potion or a magic wand to take away the pain and suffering right now. But NO TREATMENT PROVIDES that. Frequently medications or various types of treatment can help you to start feeling well ENOUGH to do the things that you haven’t felt like doing or that you’ve been putting off doing. And once you do start exercising, eating right, getting enough sleep, etc., your behaviors start reinforcing the positive neurochemistry and it’s a happy feedback cycle.

But...maybe you’re doing “all the right things.” You’re getting sunlight every morning, you’re exercising 30” daily, you’re meditating, journaling, attending talk therapy, eating a healthy diet full of fruits and vegetables and Omega-3’s. You’re taking your meds (if you’re prescribed them). You’re taking care of your family and loved ones, working to resolve stressful or financial or medical issues. And you still feel like crap. That can happen, probably more frequently than we’d like.

It’s important to reflect: What have you learned about yourself in these moments? How has it made you stronger? What have you realized you can accomplish, even when you’re not feeling well? The stressed and depressed brain likes to only focus on the negative, while it can minimize, negate, or even deny the positives! It may be that you’ve done more than you’ve realized. Maybe you come home from work exhausted but you’re still going to work and earning an income for your family. Maybe you’re struggling through your marriage or love relationship, but you’re both doing what you can to make it work. Maybe your kiddo is struggling at school but you’re doing everything you can to make sure they get tutors, or extra help and attention. Maybe you’re not feeling emotionally well but you gave someone at work a kind word or gesture. Maybe you’re trying to string together meals on a tight budget, but you always make sure your family has something nutritious to eat, and nobody ever goes hungry. Maybe you’re “white-knuckling it” to try to survive your alcohol or drug cravings, going to AA, but still have to fight with it every minute of every day. But you’re still sober. These, while they may be commonplace, are things you have accomplished despite feeling ill, unwell, not yourself, low energy, depressed, unmotivated, or anxious. And these “small” things as you think of them, are big things for the people you’re doing them for. And these moments have to be celebrated, otherwise the emotional weight of all that feels like is on your shoulders can feel too crushing at times.

The goal in this? Keep fighting the good fight. Keep trying. Do everything in your power to fight to feel better. Even if it’s only by inches every day. Time will pass regardless, so 3 months from now, you can have three months under your belt of good health and emotionally healthy habits which put you on the road to feeling better (even if it’s only eventually or by small increments…) or 3 months can pass where you do nothing to make yourself feel better. The choice is and always has been yours.

So, if you found this information helpful, please like, subscribe, and follow us! Tell your friends. We’re @AndersonClinicCincy on Facebook, Instagram, and TikTok. And you can find our Psych Waves podcast on Apple and Spotify. And if you happen to be in the Cincinnati area and are looking for assistance with treatment-resistant depression, anxiety, or PTSD, give us a call at (513) 321-1753. Start feeling better faster!

Gina PerkinsOctober 13, 2025