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Suffering from depression, uncontrollable anger, compulsive cross dressing and gambling. Had heart attack. Should I seek psychiatric assessment?

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Practicing since : 2004
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I am 74 and male, currently suffering with depression. My GP looks as if he is successfully treating it. During many hours of a crying time, my whole life spread before me. I realised that I had many trauma's (7). I realised that I suffer with ADD, which has in my opinion encouraged, at a time when I could not completeboring tasks, no matter how urgent, compulsive cross dressing and gambling to provide excitement. I have on occassions massive anger surges which has historically caused problems socially, has given me a heart attack and caused my current depression. In the rage I act impulsively which is very worrying. Twice in my life Psychiatric examinations were mentioned but never acted upon. When my GP has sorted my Depression and BP out should I seek Psychiatric Assessment. How long in hours would an assessment take, and is it possible that I might need to go inside, at least to start the treatments. DoubleD
Posted Mon, 16 Apr 2012 in Mental Health
Answered by Dr. Ashish Mittal 13 hours later
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     74 year old male
•     Known case of Depressive disorder
•     Past history of heart attack and cross dressing
•     Complain of low mood and guilt over past
•     Currently on some treatment from GP with improvement

In depression patient usually have ideas of guilt. If we see your query, it is full with negative life incidence in your life. Everybody have positive and negative incidences in their life but in depression people think only about negative past life experiences. It is called SELECTIVE ABSTRACTION of past negative life experiences and feeling excessive guilt. This symptom will improve after full remission of depression. Cognitive behavior therapy also help in treatment of mild to moderate depression specially when it is present with cognitive distortions (like SELECTIVE ABSTRACTION).

Psychiatric examination is done to diagnose psychiatric illness. The major role of psychiatric examination is to help in initiation of treatment. Your GP has already examined you and they usually have training for diagnosing common psychiatric problems and treating them. You are also improving with treatment. So there is no much need for further psychiatric examination.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
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