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What Causes Severe Depression?
Question: I have lost any desire to live. Epileptic. Each day I wake up sick. Don't want therapy. It has been a blind alley for me. I need a plan to work on my depression. Can't figure one out. Thanks for any help.
Brief Answer:
Please elaborate the symptoms in follow up question
Detailed Answer:
Hello,
Thanks for choosing HEALTH CARE MAGIC for your health related queries.
You have mentioned that you have lost desire to live. You also also have epilepsy. I would like to ask more details that what are main symptoms you are having. Please describe in follow up question-
- What are the main symptoms of depression that are causing distress to you?
- You have mentioned that you have lost desire to live. If you have ever made plans to harm or kill self?
- Provide a little detail about age, sex, occupation and any family or friend support available.
- If you find anything positive in day to day routine?
- If you have symptoms of hopelessness, worthlessness and helplessness?
- Write a little detail about your sleep, appetite and sexual life.
- Since how long you have symptoms of depression? Is epilepsy a reason of depressive symptoms or aggravating depression?
- Any other significant thing that precipitated or aggravated the symptoms?
- You are on Xanax, Gabapentin, Venlafaxine. If Venlafaxine caused improvement of symptoms or not?
- Whether you have any associated complaints of anxiety?
Please provide these details in follow up question so that I can work up and help you in moving out of depression. Also write why don't you want to take drug therapy?
Thanks
Dr. Seikhoo Bishnoi
Consultant Psychiatrist and Psychotherapist
Please elaborate the symptoms in follow up question
Detailed Answer:
Hello,
Thanks for choosing HEALTH CARE MAGIC for your health related queries.
You have mentioned that you have lost desire to live. You also also have epilepsy. I would like to ask more details that what are main symptoms you are having. Please describe in follow up question-
- What are the main symptoms of depression that are causing distress to you?
- You have mentioned that you have lost desire to live. If you have ever made plans to harm or kill self?
- Provide a little detail about age, sex, occupation and any family or friend support available.
- If you find anything positive in day to day routine?
- If you have symptoms of hopelessness, worthlessness and helplessness?
- Write a little detail about your sleep, appetite and sexual life.
- Since how long you have symptoms of depression? Is epilepsy a reason of depressive symptoms or aggravating depression?
- Any other significant thing that precipitated or aggravated the symptoms?
- You are on Xanax, Gabapentin, Venlafaxine. If Venlafaxine caused improvement of symptoms or not?
- Whether you have any associated complaints of anxiety?
Please provide these details in follow up question so that I can work up and help you in moving out of depression. Also write why don't you want to take drug therapy?
Thanks
Dr. Seikhoo Bishnoi
Consultant Psychiatrist and Psychotherapist
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
I feel sad all the time, cry a lot, I look at things and imagine them wanting love but not having any. I don't see anything positive in my life worth getting up for. All food makes me sick. My husband seems that he doesn't even like me, let alone love me. Sex doesn't interest me. I don't think any of my meds works to increase my depression, but maybe I ought to watch out more to see. I don't like to sleep, in fact I start feeling bad when it gets closer to time to sleep. I
don't especially want more drugs, they really have not helped my psychiatric
symptoms and I have considered suicide but not to the point of planning it. I can't think really of anything that precipitated these intense feelings of
depression, but I can't remember them not being here. Have a lot of anxiety, have been diagnosed with PTSD and dissociation. There has to be a way out of this but I just am very tired. No particular support system, I taught children with multiple disabilities in an urban school setting, but I had two seizures at work, first time needed staples in my head, next one I fell down a flight of
stairs. I know the principal wanted me out of there because I was a liability.
My epilepsy is really not depressing, in fact I felt a diagnosis was good because I had seizures for years but they were never properly diagnosed. I appreciate your attention to my inquiries and look forward to if you give me help.
don't especially want more drugs, they really have not helped my psychiatric
symptoms and I have considered suicide but not to the point of planning it. I can't think really of anything that precipitated these intense feelings of
depression, but I can't remember them not being here. Have a lot of anxiety, have been diagnosed with PTSD and dissociation. There has to be a way out of this but I just am very tired. No particular support system, I taught children with multiple disabilities in an urban school setting, but I had two seizures at work, first time needed staples in my head, next one I fell down a flight of
stairs. I know the principal wanted me out of there because I was a liability.
My epilepsy is really not depressing, in fact I felt a diagnosis was good because I had seizures for years but they were never properly diagnosed. I appreciate your attention to my inquiries and look forward to if you give me help.
Brief Answer:
Cognitive Therapy, life style modifications and brain stimulation will help
Detailed Answer:
Hello thanks for providing me details about your symptoms. After reading all of your history I would like to summarise it before going to proper management.
You have persistent sadness, crying spells, hopelessness (nothing positive in life) , helplessness (poor support from husband), poor desire of sex. You also have idea of worthlessness (considering yourself a liability). You have death wishes also. Seizures are associated medical illness but they are not much distressing. You don't want to take drugs because they make never helped.
Now coming to management-
As it is evident from your summary that you have Moderate to Severe Depressive Episode. Depression is a mood disorder and it needs treatment in form of medicines, psychological methods and lifestyle changes. You don't want medicines so we are left with other two.
- Cognitive Therapy can help in your situation. Cognitive therapy is a modality of treatment which is based upon interplay of thoughts of HOPELESSNESS, HELPLESSNESS and WORTHLESSNESS. In cognitive therapy therapist and patient work in multiple sessions and try to find out abnormal faulty thought process and cognitive distortions. Once abnormal thought process is found then therapist and patient work to correct them. If we go by one example-
Like an individual called someone and due to busy schedule the phone was not picked. In normal cases we forget such day to day things, but the patients of depression they may make "selective inference" from episode that they are being ignored or no one care for them.
I would like to give one more example of cognitive distortion is "generalisation". For example if an individual fails to do a particular work in office, he may start to think that he is worthless or he can't do anything positive. In this individual make generalisation of one episode and implement such abnormal distortions in his whole life.
The main objective of cognitive therapy is to make individual realise about these cognitive distortions. After realisation the patient start to work to improve such faulty thought processes. I would advise you to consult a good psychologist for proper help in such situation and for sessions of cognitive therapy.
Life style modification will help to supplement non-medicinal treatment and result in improvement. I would request to follow following things for improvement of your symptoms
- Have good sleep, at least 7 hours a day. But don't sleep till late in morning.
- Take diets rich in proteins and carbs and low in fats. This will help to increase
tryptophan in brain and will improve concentration and focus.
- Omega-3-Fatty acids supplements help to improve such symptoms. Diets rich in these fatty acids are walnuts, hazelnuts, soybeans, flex seeds etc.
- Spend your time in watching a good movie or in outing at least once a week.
- Exercise daily and this will help to improve endorphins concentration in brain. This will lift your mood.
- Vitamin B12 supplements will also help to improve such symptoms.
- Listen good music in low volume to keep yourself relaxed.
- Try to ignore the bad behaviour of others including your husband. You have to help yourself in improving these symptoms.
I am sure these life style changes will help to build your confidence and your symptoms of depression will improve.
Now if the situation doesnt improve with these methods and COGNITIVE THERAPY then other treatment modalities can be tried. Brain Stimulation methods like RTMS (repetitive TRANSCRANIAL MAGNETIC STIMULATION) and Vagus Nerve Stimulation (VNS) have almost equal efficacy when compared to medicines. These methods are also free of side effects.
rTMS is a method in which stimulation of brain using a magnetic field is done. This results in improvement of depression and lifts mood. The method is free of side effects and is safe. Consult a good psychiatrist nearby for this modality of treatment.
Hope this helps you, you can ask again if you have more doubts regarding the treatment I have mentioned or some other doubts.
Thanks,
Dr. Seikhoo Bishnoi
Cognitive Therapy, life style modifications and brain stimulation will help
Detailed Answer:
Hello thanks for providing me details about your symptoms. After reading all of your history I would like to summarise it before going to proper management.
You have persistent sadness, crying spells, hopelessness (nothing positive in life) , helplessness (poor support from husband), poor desire of sex. You also have idea of worthlessness (considering yourself a liability). You have death wishes also. Seizures are associated medical illness but they are not much distressing. You don't want to take drugs because they make never helped.
Now coming to management-
As it is evident from your summary that you have Moderate to Severe Depressive Episode. Depression is a mood disorder and it needs treatment in form of medicines, psychological methods and lifestyle changes. You don't want medicines so we are left with other two.
- Cognitive Therapy can help in your situation. Cognitive therapy is a modality of treatment which is based upon interplay of thoughts of HOPELESSNESS, HELPLESSNESS and WORTHLESSNESS. In cognitive therapy therapist and patient work in multiple sessions and try to find out abnormal faulty thought process and cognitive distortions. Once abnormal thought process is found then therapist and patient work to correct them. If we go by one example-
Like an individual called someone and due to busy schedule the phone was not picked. In normal cases we forget such day to day things, but the patients of depression they may make "selective inference" from episode that they are being ignored or no one care for them.
I would like to give one more example of cognitive distortion is "generalisation". For example if an individual fails to do a particular work in office, he may start to think that he is worthless or he can't do anything positive. In this individual make generalisation of one episode and implement such abnormal distortions in his whole life.
The main objective of cognitive therapy is to make individual realise about these cognitive distortions. After realisation the patient start to work to improve such faulty thought processes. I would advise you to consult a good psychologist for proper help in such situation and for sessions of cognitive therapy.
Life style modification will help to supplement non-medicinal treatment and result in improvement. I would request to follow following things for improvement of your symptoms
- Have good sleep, at least 7 hours a day. But don't sleep till late in morning.
- Take diets rich in proteins and carbs and low in fats. This will help to increase
tryptophan in brain and will improve concentration and focus.
- Omega-3-Fatty acids supplements help to improve such symptoms. Diets rich in these fatty acids are walnuts, hazelnuts, soybeans, flex seeds etc.
- Spend your time in watching a good movie or in outing at least once a week.
- Exercise daily and this will help to improve endorphins concentration in brain. This will lift your mood.
- Vitamin B12 supplements will also help to improve such symptoms.
- Listen good music in low volume to keep yourself relaxed.
- Try to ignore the bad behaviour of others including your husband. You have to help yourself in improving these symptoms.
I am sure these life style changes will help to build your confidence and your symptoms of depression will improve.
Now if the situation doesnt improve with these methods and COGNITIVE THERAPY then other treatment modalities can be tried. Brain Stimulation methods like RTMS (repetitive TRANSCRANIAL MAGNETIC STIMULATION) and Vagus Nerve Stimulation (VNS) have almost equal efficacy when compared to medicines. These methods are also free of side effects.
rTMS is a method in which stimulation of brain using a magnetic field is done. This results in improvement of depression and lifts mood. The method is free of side effects and is safe. Consult a good psychiatrist nearby for this modality of treatment.
Hope this helps you, you can ask again if you have more doubts regarding the treatment I have mentioned or some other doubts.
Thanks,
Dr. Seikhoo Bishnoi
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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