HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Suggest Treatment For Depression And Insomnia

Posted on Tue, 19 May 2015

Question:
Hello
I have a tough life. Been depressed for a while and its getting worse. I have no interest in doing anything and i am seeking the attention of several people and the gap is not being filled. I feel lost and more like alive but dead. Irritable and space out alot and i have insomnia. Not a fan of sleeping pills or anything that makes me drowsy what can i do? I have this hole inside of me And it kills me every second of the day i feel i am worthless and tired of living. I wish death but i dont have the courage to seek it i am just so tired

Answered by Dr. Tushar Kanti Biswas (6 hours later)

Brief Answer:
Acute depression

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
You are having symptoms of acute depression,whatever may be the underlying factors. You have loss of interest or pleasure in life (feeling worthless and tired of living) with thoughts of death or dying ;also having changes in sleep patterns (insomnia).Do you have any medical illness or similar episode earlier ?
A detailed history including family history ,work place and drug history ,if any will help in getting to the root of depressed mood.
Any way you need psychotherapy to cope with decreased self-esteem and demoralization and to improve outcome.
You need to consult a psychiatrist for that purpose and without any delay. You may require antidepressant drugs too to induce remission and on longer term maintenance to prevent recurrence.
You will be able to overcome the current episode.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Tushar Kanti Biswas (2 hours later)

I have been feeling the same for almost 5 years
After the death of my mother and handling the responsibility of life alone
I also had to quit medical school because of the absence of financial aid
I am not married and not in a relationship
I have tried to use cipralex pills after visiting a psychiatrist but stopped due to fear of addiction
I prefer not to take any anti depressants but i have used over the counter sleeping pills which increased my weight tremendously.
I avoid psychotherapy because i would rather heal without the need of medication

Answered by Dr. Tushar Kanti Biswas (8 hours later)

Brief Answer:
Depressive Disorder

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

It seems you have dropped out of treatment and discontinued medication cipralex (escitalopram ) out of fear for addiction. However it is a non-addicting drug. The most effective intervention for achieving remission and preventing relapse is medication; combined treatment, incorporating psychotherapy is better than drug alone.

For your information, there is no ideal antidepressant.

Avoid sleeping pills at random.

Newer antidepressant such as Venlafaxine with its relatively linear dose-response curve has better drug profile and an extended-release form is available. Even drug can be taken by transdermal route e.g.selegiline ( a MAOI/Monoamino oxidase- highly effective).

If you don't like to undergo any psychotherapy or any drug for that matter ,you can try Transcranial magnetic stimulation (TMS), a newer modality of treatment which is approved for treatment-resistant depression and has been shown to have efficacy in several controlled trials.
A mental health specialist can be consulted for that purpose.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Vaishalee Punj