45. Gianni

Chapter forty-five

Gianni

Wednesday, April 30, 2025

I ’m sitting at my laptop, staring at the screen. My heart is pounding inside my chest with the growing unease wrestling inside me.

I’m really doing this. I’m actually speaking to a psychiatrist.

The loading symbol in the center of the video call finally stops, replaced by a smiling middle-aged man sitting in front of a cherrywood bookshelf.

“Good afternoon, I’m Dr. Slader. Would you mind confirming your name and date of birth before we get started?”

Once I do, we get into it, and slowly, the nausea starts to subside. “So I see you filled out the forms I sent ahead of time. I appreciate that because it allows us more time to get into what you’ve written and allows us to discuss a plan that works best for you and your schedule and meets you where you’re at right now. ”

I like that this is a discussion and not just him telling me what he thinks I need to do to get better. “Do you mind if I ask you some questions about that form?”

“Of course not. Go right ahead,” he urges me.

“Okay, so the PHQ-9 is a screening tool for depression, right?”

“Yes, it allows us to look objectively at what you’ve been going through without allowing subjective opinions to muddle your diagnosis. But at the end of the day, whether we diagnose you with one thing versus another doesn’t matter as much as working through what it is that you want to overcome.”

“That makes sense, I guess. So, where do we go from here?” I ask, feeling better about this whole situation. I like that I can just shut my laptop if this becomes too overwhelming for me, and the fact that I’ve never met this person in the real world is also really helpful.

“Well, let’s start by discussing some answers you filled out on the form and determine from there. Sound like a plan?”

I nod, and that’s exactly what we do. We spend the next forty-five minutes going over all of my answers, and at the end, unsurprising to anyone, I’m diagnosed with persistent and major depressive disorder. I met the criteria of PDD as a result of the length of time I’ve felt this way and MDD because of the situations that exacerbated it.

“It sounds like at one point you hadn’t been open to speaking with a therapist, but you might be more open to that now, is that right?” I really appreciate that he doesn’t put words in my mouth and clarifies the things I’ve said. That’s been a huge fear of mine going into this .

“That’s right. I think I’d benefit from just getting some things off my chest, but I’m also open to learning some healthier coping mechanisms rather than just sleeping the day away,” I say, sucking in a breath through my nose as I try to steady my breathing before speaking the next words. “I also think it’s time to try medication too.”

“That’s really great, Gianni. It’s clear that you’ve come a long way from your initial feelings toward your mental health to where you are now, and I’m truly so excited to see where you go from here with the right support. I have a colleague in my office who can see you as early as this Friday for your first therapy session. Does that work?”

We get it scheduled, and when we’re done, we discuss medication. “So there are a lot of medications that work very well for depression, but I’d like to start you off with what we consider ‘first-line’ therapy. That would be a medication called an SSRI or selective serotonin reuptake inhibitor, which essentially means that this medication blocks your body from getting rid of the serotonin you produce naturally and allows you to maintain more of that. Serotonin is a neurotransmitter or hormone produced in the brain that regulates mood and allows you to experience emotions, such as happiness. It plays a huge role in regulating your mind and body, but as with any medication, there are potential side effects.”

He spends the next couple of minutes going over those with me. “The most common side effect we see with these medications is sexual dysfunction. Now, some people would say that if they had to choose between not being depressed and having a quality sex life, they’d rather not have depression, but I’m here to tell you that you don’t have to choose. I find all too often that people get help, take these medications, and see tremendous improvements. But they also experience sexual side effects, and rather than saying something, they remain quiet. There’s no reason to do so though. Yes, it’s true that it can be very scary to find something that works for you and then potentially have to stop it and try something else because of a side effect that may not be hindering your well-being too drastically, but there are other options. And again, you may not experience these side effects at all. It doesn’t happen to everyone, but I just want you to be fully aware that if they do, just let me know, and we’ll try something else. Medicine has come such a long way in the last several decades. If you have any concerns at all, please don’t hesitate to reach out.”

I’m not exactly thrilled at the idea of my libido suddenly tanking, especially knowing that Lark felt so undesirable in her last relationship. But the fact that he’s making sure I know that it’s a possibility ahead of time makes me feel a lot better.

“I won’t. Seriously, thank you for going over all of that with me. I just have one last question before I let you go.”

He nods, urging me to go on. “How long does this sort of thing take to work?”

“It’s different for everyone, but typically, you’ll start to see an improvement in your mood after about two weeks, but it reaches its peak efficacy at around four to six weeks. So give it about a month or two and if you don’t see much improvement, we’ll try something else out. There’s no reason to suffer in silence,” he assures me.

There’s no reason to suffer in silence.

That’s something Lark has told me in her own way many times now, and I think I’m finally starting to understand the truth behind that statement.

“Thank you, Dr. Slader. I appreciate your time, and I look forward to following up next week,” I tell him sincerely.

“You’re very welcome, Gianni. It was great getting to meet you, and I’m excited to hear about your progress next week. Have a great rest of your day,” he tells me before ending the call.

Now that I’ve taken some time for myself, it’s time to show my girl just how dedicated I am to her happiness.