Combination of Therapies Proves Effective in Treating Depression

For as long as he can remember, William Storey has been plagued by depression. It is the demon that left him feeling hopeless and lonely as a child and has thrown one roadblock after another in front of him as he’s traversed life’s path.

Photo by Jordan Pysz.

William Storey, right, and his father, Peter, relax during a recent visit with
Robert Pollack, MD

“My specific experience with depression has been one of near paralysis,” says the now 25-year-old, who also battles attention deficit hyperactivity disorder, bipolar disorder and Asperger’s syndrome, a higher-functioning form of autism.
“The most common way people respond to stimuli is either by fight or flight. They either take on a task or problem, or they run from it. But there’s a third response that is not as well established and that response is to freeze up and do nothing.
“My experience with depression is very similar to that. I have trouble doing certain things because I don’t feel capable of doing anything. And because I don’t do anything, I never feel better about my ability to act, or change myself or the world around me.”
What has suffered the most as a result of William’s inability to act is his education. Though he has excelled at times – making straight A’s in middle school, for example – his battles with depression derailed him all through high school and into college.
After being held back in the tenth grade and twice changing schools, William eventually earned his GED. However, he soon faced another obstacle when he had to secure an approval from the state board of regents to take classes at a college in Georgia, where he lives.
It was at around that time that William’s father called Robert Pollack, MD, a friend since their days together at Yale University, to see if there was an alternative to the various anti-depressants William had long been taking that could help him get on track.

Something New

At his Fort Myers-based practice, Psychiatric Associates of Southwest Florida, Dr. Pollack regularly treats his patients using emerging therapies that are based on pioneering discoveries about the brain.
Those therapies include genomic testing to determine which antidepressant might be most effective according to the patient’s genetic profile, as well as transcranial magnetic stimulation (TMS) and theta-burst stimulation (TBS), the latter of which use magnetic pulses to rouse areas of the brain and relieve depression.
Since 2015, Dr. Pollack has also used ketamine, a drug introduced in the 1960s as an anesthetic agent. This medication can alleviate suicidal thoughts and act more quickly than many antidepressants. Dr. Pollack estimates that 72- to 75-percent of his patients treated with ketamine have had a positive response but notes that ketamine alone does not always achieve the desired result.
“Ketamine is not magic,” Dr. Pollack emphasizes. “Nor is genomic testing, TMS or TBS. But what we’ve found is that if you put some of these therapies together, you’re going to come very close to getting the response you want. Just like the use of combinations in the treatment of cancer and other horrendous diseases, we did the same for William.
“The first thing we did with him was make a better diagnosis through genetic testing. Then, after isolating the neurobehavioral difficulties we were dealing with, we developed a treatment program for him using these combinations.
“His regimen was using genomic testing to get better control of his needed medications; iv ketamine infusions to gain access to his depression; and theta burst stimulation to further enhance the activity of the glutamate that was stimulated by the ketamine. The associated changes in cognition allowed me to begin doing some cognitive behavioral therapy with him until he was ready to begin more intensive therapy at home.
“I suspect that two years ago, when I first started treating William, the therapist would have done no good at all. But after using this combination of treatments, we got him to a point where he was ready for talk therapy, and now that therapy is working.”
William concurs. He says that over the course of the last two years, he has slowly developed an ever-increasing willingness to take on tasks and work them until he achieves a specified goal, which is something that heretofore was completely foreign to him.

“Substantially Better”

“For the first year that I was in Dr. Pollack’s care, it was like a new door had been opened up to me,” William explains. “And now, in the past ten or eleven months, things have started to click. I’ve started to figure out how to use what these treatments have done for me.
“I think the best example of that is, at the start of 2018, I made a conscious decision to lose weight. I weighed three hundred eleven pounds at the time, so I started dieting and weighing myself every day, and as of right now, I weigh two hundred thirty pounds.
“That’s all a result of me making an effort to lose weight and figuring out how to take that information, set a goal and then achieve the goal. That doing part is the thing that, prior to having these treatments, I was never able to do.”
William’s newfound ability to take on a task, set a goal and follow through to achievement has manifested itself in other ways as well. He recently joined a gym and is searching for a new school to continue his education.
“I go to the gym for about an hour six days a week,” William reveals. “That’s a huge shift. And in terms of school, I really feel that if I can find the right school, I will perform very well and not suffer from the same problems that I had for so many years before.”
William says he sees Dr. Pollack for his ketamine and theta-burst treatments once every two months and strongly believes that it was the combination of treatments that Dr. Pollack came up with that finally got him moving forward with his life.
“Having a knowledgeable therapist such as Dr. Pollack is really critical because he’s responsible for one of the biggest shifts that have occurred, when he suggested in February that I start seeing a therapist again twice a week,” William says.
“I believe that has sped up my rate of improvement into a sort of recovery mode. So he has really been a godsend. He’s the one who encouraged me to keep an open mind about some of the more experimental treatments we’ve tried, and I’m glad I did.
“I’m much, much better – substantially better – than I was in the past. I have improved dramatically. It’s really kind of shocking just how much I’ve improved and how much things have changed for me since I started seeing Dr. Pollack.”

Print This Article