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Your Questions About Depression Answered
Question
letting my family downhi, i have been suffering depression & anxiety for a year now, i feel so silly for feeling like this but nothing i do makes me feel better. i make excuses not to go & see friends, my children miss out on play dates as i sometimes feel so anxious as soon as i leave the house my heart starts pounding & i feel like im going to pass out. its a real struggle to take them to school everyday but i force myself then im exhausted when i get home. how can i get over this anxiety?
Answer
Hi
Sorry you are feeling so bad and sorry to hear that you feel you are letting your family down. Of course you are not doing that - I think any parent will agree that at times (or even at many times) we feel we could do better for our children - maybe that is part of being a parent for many - but all we can really do is to do our best!
You haven’t said if you have been struggling along alone or if you have been to the doctor and have any medication or have had any counselling or CBT to help with the depression and anxiety. If you haven’t please do make and appointment for Monday morning and get some professional face to face advice. As Helen said, if you had broken your leg you would seek medical advice and not try to deal with it yourself or tell yourself you shouldn’t be feeling the pain. So it is the same with depression and anxiety.
A few things that may help - buy a small book and write in each day the small things that you have achieved - don’t think about or write down what you didn’t manage to do but write down the small things that you did achieve each day. Look back over this list each night and feel proud of what you have achieved. If you feel you would like to - maybe write down one small thing that you are going to do the following day. Remember start with small baby steps and congratulate and reward yourself with what you do achieve.
As hard as it maybe to get out - once your children are at school, is there something that you could join or take part in for you? maybe join a gym, go to a yoga class, try out Zumba, go swimming…..doing something physical helps with depression and anxiety and if you can do something that is in a group with others then do so.
How could you treat / reward yourself each day? Could it be taking time to have a cappuccino, or browsing through your favourite shop, meeting with a friend for a chat?
With best wishes - and please do go and consult a professional face to face as soon as you can!
Allison
Allison Kelsey,
Therapist, Coach, Trainer
http://www.inspirenow.co.uk
Question
Can you take over the counter diuretics with lithium?Can you take over the counter diuretics with extended release modified lithium? It’s just that I am finding I have swollen hands (as my rings have all become tight) and I am bloated slightly around my face and feet and it feels like water retention? Or am I best to not buy and take these in case I upset my lithium balance and lose too much water? Thanks for your help.
Answer
Dear …
I think that you’re correct in saying that these preparations could upset your lithium balance. Many diuretics reduce the excretion of lithium by the kidney, even herbal preparations. Diuretics may cause lithium toxicity, (e.g. nausea, vomiting, diarrhoea, muscle weakness, drowsiness, confusion). Lithium toxicity can be life threatening. Therefore, diuretics should be avoided if possible and if they must be used, the dose of lithium should be reduced and blood levels closely monitored by your doctor.
Blood lithium levels should be checked every three months at a minimum. Kidney function and thyroid function should be checked every six months.
Fluid retention (oedema) may occur with higher doses of lithium; however it is also possible that your symptoms may not be due to some other physical cause (e.g. kidney problems). I would recommend that you see ideally your treating psychiatrist or your General Practitioner. Side-effects with lithium are usually dose related and your doctor may decide after excluding any physical cause, to reduce your lithium dose. However one has to weigh up the risk of side-effects versus risk of relapse. You can only do this by having an informed discussion with your treating doctor. Remember many over the counter medications, including herbal remedies can interact with prescribed medications, especially lithium and before taking any of these you need to let your treating doctor know.
I hope this helps.
Dr Rhinds, BM (Soton), BA, BSc (Hons), M.Med.Sc., MRCPsych. Consultant Psychiatrist
Question
Treatments Not WorkingHello,
I am sitting awake once again and often search the site for help and answers as my brain travels one thousand miles an hour in a desperate search for an answer to everything and/or negative thinking about everything. I decided that tonight I would buck up the courage and create an account and contact you because I am at my wits end and are so very desperate I don’t know where to turn.
I have suffered with Depression and Anxiety since I was 19 and in that 13 years I have had 4 serious episodes requiring lengthy hospital admissions. I am desperately trying to get through a recent serious severe episode that required hospitalisation and ECT Treatment.
I was put on Lithium and Venlafaxine (which appeared to have worked before in previous instances) and underwent 10 sessions of electrconvulsive therapy (ECT) towards the end of last year. I am better than when I first went down with this episode (I required hospilisation, was a high suicide risk and was a complete state) and came out from hospital in December after a four month stay.
It is now February and six an a half months after all this started I am nowhere near 100% better and my community psychiatrist (I saw a different one when in hospital) has now added yet another anti-depressant to my list, that being Citalopram. It has never taken me this long to fully recover from a serious episode and I am worried and at loss as to what lies in store for me, apart from misery and constant depressive lows.
I have never heard of someone taking both Venlafaxine and Citalopram together and I have searched on the web and can find nowhere and nobody claiming to be dong to same, however I have found claims that it is quite safe to take the two.
I know nobody has my golden answer of when I will be completely better and when I can resume a regular working life. But this is the longest time it has ever taken me to get to a stage where I am not feeling down all of the time and in such a desperate and fed up state. I am losing all faith in everything after, what I feel is enduring high dosage drug therapies, hospital admission and even ECT.
I know everyone on here has their own problems and I by no means what to overtake or say I am worse but any advice or help would be very much appreciated, especially surrounding the areas of the following:
Has you heard or know anyone that takes the Venlafaxine and Citalopram combination and what is the feedback?
I have only been on the Citalopram medeication for around one week and could it be this that is making me feel so terribly low and emotional, more than I was before? Should I just expect this whilst it kicks in (as in is this the “it will get worse before it gets better” syndrome, if this statement is true (?) perhaps)?
My doctor insists that anti depressant medication does not make you tired, it is the depression and lack of motivation to get out of bed that does but whilst I appreciate depression does contribute to this, I am on rather high doses of Lithium and Venlafaxine.and my tiredness and lethargy is sometimes extreme, I have slept for 24hrs, waking only breifly, on more than one occasion and often sleep more than 12 hours. Can you advise?
I am now getting low blood pressure and higher than normal calcium readings in blood tests, is it the medication doing this or is the medication causing something else to go wrong in my body? My doctor just says they will keep an eye on it as they do my Lithium levels.
I have been referred for one to one psychotherapy involving cognitive behavioral therapy, is it of any use?
I am currently taking Lithium 900mg, Venlafaxine 300mg and Citalopram 20mg.
If anyone has any advice or experience on any of the above your help would be very much appreciated
Yours at my wits end and desperate….. wondering whether they have they run out of options/ideas for me now…..
FC
Answer
Dear FC,
I’m sorry that it’s taking some time for you to recover from your illness. The exact nature of your depression/anxiety and type of symptoms can help to guide your treating psychiatrist. The use of several drugs ( known as augmentation) to treat treatment resistant illness is not uncommon psychiatric practice, however none has a strong evidence base and most augmenting strategies are based on small case reports. The rationale for augmentation is to target different brain receptors to maximise the chance of treating the resistant illness. Lithium has the largest evidence base and is often used with venlafaxine. I am not aware of any evidence for adding citalopram to this combination, however when treating treatment resistant illnesses psychiatrists have to have a flexible approach. However this is an unusual combination and you are on a high dose of venlafaxine. I have some concerns that you may suffer from side effects. You do need to discuss this further with your treating psychiatrist so that they can explain their rationale for this treatment combination and hopefully reassure you. I am pleased to hear that you have been referred for Cognitive Behavioural Therapy and this is worthwhile pursuing. Lithium can cause a rise in calcium levels and your treating psychiatrist/General Practitioner should monitor this. Usually doctors do not treat low blood pressure but for reassurance you should go and see your GP. This is unlikely to be related to any of the medication you are on.
I hope this helps.
Best wishes
Dave
Dr Rhinds, BM (Soton), BA, BSc (Hons), M.Med.Sc., MRCPsych. is a Consultant Psychiatrist working within the NHS
Question
AnxietyHi
How can I rid myself of this dreadful feeling and also destress. The two together are crippling!
Many Thanks
Answer
If you wake up feeling anxious it’s because you are thinking negative thoughts
along with seeing negative pictures. You need to keep telling yourself positive
things and focus on positive images and the more you do this the easier it becomes
so stick with it. When you wake up play positive music and find one little
positive song that you can hum to yourself over and over as it been proven that
doing this changes your state. Your mind can’t hold conflicting feeling so while
you are humming a happy positive song you can’t feel negative. Marines sing in
times of stress as it changes their state immediately so do the same. Also take
Astralagus as it eases stress and cut sugar out of your diet as sugar increases
anxiety. Caffeine makes us anxious it’s not enough to give up coffee you need to
switch to caffeine free tea and avoid coke and diet coke as they are packed full
of caffeine that can cause and increase anxiety. I do hope this helps and please
persist as often we don’t realise we are getting better because change is
retroactive and cumulative.
Very best
Marisa Peer
Psychotherapist, Hypnotherapist, coach and behavioural expert
Author of ‘Ultimate Confidence’ and’ You Can Be Thin’
Question
Always live in depressionHi
I am very irritating because i live in alway depression of anything…if one depression finish i will start next one.
I will be never happy in my life. I am very sensitive person. If some one tells me that i dont like the i am starting thinking on this for next many hours & getting depressed.
I have addictions of eating gutkha & drink wine. I want to get rid from this habit. I tried for this since last 3 years but still not got success & this is the major reason of my depression.
Answer
Hi
Thanks for your question and I apologise for the delay in replying to you. First of all you have taken a great first step in reaching out for help. Have you been to the doctors at all and spoken to them about your feelings and your depression to get a diagnosis? If not, then I would suggest this is one of the first steps as speaking face to face to someone could really help. Your doctor should be able to advise if it is indeed depression that you are suffering and if appropriate maybe prescribe some drugs and talking therapy that can help.
I would also suggest that you speak to your doctor to see if he /she can help you in finding someone who can help you to get rid of your addictions of wine and gutkha. As you have already tried to overcome them you are probably already aware of the unpleasant and unhealthy effects of these addictions and finding a professional to help you could mean that you can easily and quickly let go of these destructive habits. In the meantime - I wonder if you can consider what it is that these things (wine and gutkha) get for you - i.e. what need do they satisfy in you? For example - do they make you feel more confident? Do they make you feel more relaxed? Do they ease your sensitivity? Once you have discovered what it is you believe you get from these - I wonder if there is another (more healthy) way to get the same outcomes? Is there a sport you could do? Could you take walks outside? Could you do yoga? Could you swim? Could you take a class in something unrelated to your work that would give you another interest and focus? What are your dreams? What have you always wanted to do but haven’t done yet? What are you passionate about? What makes you excited? Is there a way that you can make the decision now to make a step towards that thing? When you have that excitement / that direction it could be that you will no longer want to do self destructive behaviours?
Please believe that you can and you will be happy. Everyone has the right and the ability to be happy - and it doesn’t need to depend on what we “have” - it is a state of mind and how we allow ourselves to be. I wonder could you allow yourself to be open to the possibility that you could be happy? That would be a step in the right direction? What would be one tiny step you could take today towards that? And then having done that what could be another tiny step you can take tomorrow?
With best wishes - and please do go and consult a professional face to face as soon as you can!
Allison
Allison Kelsey,
Therapist, Coach, Trainer
http://www.inspirenow.co.uk