30-06-2025
A Simple Cheek Swab Helped Her Finally Find Depression Meds That Worked
Alabama native Lisa Roberts, 65, had been navigating depression for most of her adult life. Roberts, who works in cybersecurity, notes that major life changes such as changing careers, raising a child and facing challenges as a single parent prior to marriage intensified her mental health struggles—a large part of the reason she ultimately decided to seek treatment for her depression.
On top of managing her own depression, Roberts had also been a caregiver on and off for her mother since 2021. In July 2024, her mother came to live with her again after her husband was no longer able to care for her. That month while living with Roberts, her mother passed away from heart failure, and Roberts struggled with the grief.
'I just realized that I was not managing myself, my life, my family or anything the way that it should be,' says Roberts after recognizing her symptoms of depression were intensifying. 'I knew something was off, and I just wasn't feeling quite right.' (Learn more about depression after illness here.)
Sharing her mental health concerns with her healthcare provider, Roberts was soon connected with Whitnee Brown DNP, CRNP, FNP-C, PMHNP-BC, a psychiatric and family practice nurse practitioner trained to help with mental health conditions.
'In talking with Dr. Brown, we started going through some of the things I was going through and officially determined that I was going through depression,' says Roberts.
Dr. Brown introduced Roberts to several therapeutic tools, including meditation, writing and the option of medication. Roberts had tried anti-depression meds in the past, but found they weren't effective for her. 'The medication never worked,' says Roberts. 'It would either be too strong [or] it wouldn't work for me in the way that I needed it.'
That experience made her hesitant to try other types of antidepressants again. 'When she mentioned medication, the past popped up,' says Roberts. 'I told her, 'I don't know if that's a route that I want to take.''
Dr. Brown worked with Roberts to better understand her history with mental health medication to treat her depression.
'A lot of times you don't realize how bad you were feeling until you start feeling better.' —Lisa Roberts
'We made a list of the medications that she had previously tried in the past to see if there were any type of connections to those,' says Dr. Brown. 'First-line treatment for depressive symptoms is usually a list of selective serotonin reuptake inhibitors (SSRIs). She had trialed several SSRIs in the past, but some people have what we call a genetic variation that can prevent them from having the complete absorption of an SSRI or moderately-reduced efficacy to it. She had tried two or three, and they did not work for her. So the likelihood of us trying another one and finding success was another four to six weeks.'
Dr. Brown recognized that, due to the severity of Roberts' depression, a long trial period for the medication to kick in and see if it was effective wasn't ideal. 'We did not have four to six weeks,' says Dr. Brown. 'We needed to know. We needed to be succinct in our efforts. [A service known as] GeneSight testing offered us that, and it offered us speed, because it comes back within 48 hours of us sending it out and it being received by the lab.'
Roberts agreed to try GeneSight testing, which analyzes how your genes may affect your response to certain medications. So Dr. Brown swabbed Roberts' cheek and sent the sample in by mail.
If you've ever considered using medication for mental health but were concerned about side effects or how it might work with your unique biology, genetic testing could be worth considering. Robin Miller, MD, MHS, an internist at Triune Integrated Medicine, explains how GeneSight works.
'You do a cheek swab, send it in and the information you get back shows how a person metabolizes certain medications,' says Dr. Miller. 'There's a system in the liver where we have the ability to see how different medications are metabolized. And what GeneSight has done is used it for looking at medications to help people in terms of psychiatric issues. What it will do is tell you whether a certain medication is metabolized slowly, quickly or normally.'
Dr. Miller says genetic testing has become a key part of her practice, especially for treating people with depression like Roberts.
'It really changed the way I did things in my practice,' says Dr. Miller. 'It was so helpful. At first, I started out just testing a few people, then I ended up testing quite a few. It also helps in terms of ADD for kids and depression in kids. As a pediatrician, I don't know how you could give medications without doing this test.'
After reviewing the results, Dr. Brown and Roberts decided to try an antidepressant medication called Zoloft, an SSRI that Roberts had never taken before.
'I started it immediately once Dr. Brown prescribed it, and I'm still taking it,' says Roberts. 'Within maybe a couple of weeks I was feeling better. You know, a lot of times you don't realize how bad you were feeling until you start feeling better. And when I started feeling better, I felt as if I could just exhale. Life was a bit better.'
Roberts credits the medication, along with therapy, meditation and treadmill workouts, with improving her mental health. 'Once the medication began to work, and I continued my work with Dr Brown, I was ready to get up in the morning,' says Roberts. 'I was ready to go to work. I was ready to take on the world. I was okay to grieve. I knew I was thankful to be here.'
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This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.
