Dear XXXXXXX

Thanks for posting your query here.

There are a few aspects to your situation I would like you to consider, so that you can take positive goal directed actions.

First of all, your query about getting rid of medicines has to be considered. Your depression seems to have been prolonged for a longer period than expected. And with adequate treatment, depressive symptoms are expected to go away. However, it is possible that you may not have received adequate doses or combinations of medicines. Frequently changing anti-depressants may also not help.

I assume your goal is to get rid of the medicines and feel better. For this to happen, you will have to make sure that your depression is treated adequately. And you may need the help of more than just the medicines. This can be effectively achieved by Psychotherapy (may also be called counseling).

The second aspect I would like to focus on is the causes behind the depression. You have described specific situation which seemed to have started the problems. Insomnia is a symptom that can be seen in anxiety as well as depression. And you have mentioned that you anxiety developed after your father compared your performance with that of your neighbour.

The comparison may have been a trigger for your depression and anxiety. Not being able to perform as well as parents' expectations can be perceived as "failure". And since there was a comparison, you may have been under a constant pressure to do well in studies. This added pressure indirectly affects the ultimate performance. And once the performance is poor, it can re-inforce the depression and anxiety.

A person's thoughts are at the root of almost all his emotional problems. And, events in life do not create the emotional problems, but the person's own thinking about those events, create the various emotional disturbances. This is important for you to consider at this stage, as your depression is long standing and medicines do not seem to be helping much now. You may need to take the help of Psychotherapy, and it involves exploring one's thoughts about the events that seemed to create the depression.

Please read this short article for a better understanding of how our own thinking can lead to various emotional problems.

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Thus, it seems that you have not been able to get out of this vicious cycle of depression. To add to this problem, the medicines do not seem to have helped much.

I would like to suggest to you a few things.

1) Consider undergoing Psychotherapy, especially Cognitive Behavior Therapy (CBT) or Rational Emotive Behavior Therapy (REBT) for your depression. You may need to search for trained psychotherapists in Begusarai or nearby city. You may need a number of session, usually 6-8 sessions. Psychotherapy can help you explore your underlying thoughts that are creating the depression constantly, and you can see significant improvement in your situation. This will be helpful for you to gradually reduce the medicines and get off them.

2) Make sure that you have discussed all options regarding the medicines with your doctor. There are newer anti-depressants like Bupropion, Desvenlafaxine, etc. which are known to be effective when other medicines have failed.

3) If you haven't done already, please consider going for Thyroid hormone testing. Thyroid gland is situated on the front side of the neck, and is responsible for mood regulation. If thyroid gland does not work well, depression can be a result. And if that is the case, you may need to take additional Thyroid hormone supplements.

4) Adopt healthy life style. This includes regular physical exercise, eating healthy food, pursuing hobbies and interests, taking adequate and regular sleep, etc. You may consult a Diet and fitness expert for the same. Having a healthy life style can work as a natural anti-depressant. Physical exercise releases chemicals which can work as effectively as some very good anti-depressant medicines.

Unfortunately, I won't be able to suggest any specific medicine changes for you here, but you can always discuss these issues with your doctor. Since your depression is long standing, you will have to take efforts to make changes happen.

I hope this helps you a bit. Please let me know if you would like to discuss more about this situation. I would be glad to help you overcome your problem.

Take care.

Dr Abhijeet Deshmukh
Consultant Psychiatrist and Psychotherapist

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Hi,

Thanks again for following up.

You can contact me for Therapy sessions over phone via this website. Please contact the customer care of XXXXXXX by sending a mail to YYYY@YYYY . They should be able to arrange for a phone call between us.

It seems you have some more issues about which we can discuss over the talk and find out appropriate course of action.

Hope this suffices.

Wish you good health

Take care.

Dr Abhijeet Deshmukh

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Hello.

Thanks for letting me know.

I will arrange for the phone session. You will get a communication email from the customer care executive to fix a call with me very soon.

Thanks and Regards.

Dr Abhijeet Deshmukh.

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