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Suggest Treatment For Persistent Depression Along With Generalized Anxiety Disorder
Question: hi. i suffer from GAD and depression for the last 10 years. during last year i was on citalopram from XXXXXXX to august but it was causing me weight gain and lethargy. i then switched to effexor and that was helping me, however it caused me a lot of sleeplessness. my husband and i are now wanting to start a family and i was told by my gyno that zoloft is the safest one to be on. so i was on effexor from august to november and then switched to zoloft middle of november. i have been on zoloft till now but over the last month i have gained weight, am always tired and drowsy, like im drugged up on morphine, very irritable and angry and generally down. i am now confused whether this is from the zoloft or the withdrawl effects of effexor and i dont know what to do. my psychiatrist never answers my questions and i feel alone. i want to come off medication entirely because i dont want to pose a risk to my unborn child. please could you advise accordingly. i was weaned off effexor in 2 weeks and onto zoloft and i am now taking 150mg.
Brief Answer:
Please provide more details.
Detailed Answer:
Dear
Welcome to HCM
We understand your concerns
I went through your details. I can understand your emotions. Mental disorders are supposed to be treated with mutual confidence.
Zoloft is a good medicine for your condition. But I am amazed you are being treated for ten years. You are supposed to be cured within two to three years with a combination of medicines, psychotherapy and meditation.
Drowsiness is more due to inactivity and depression related obsessive thoughts. I am sure you will be cured with the help of cognitive behavioral therapy.
I need more of your details. Please provide as many details as possible about your disorder, mood, family, behavior, job etc in the follow up question.
God bless you.
Dr Anand PhD
Please provide more details.
Detailed Answer:
Dear
Welcome to HCM
We understand your concerns
I went through your details. I can understand your emotions. Mental disorders are supposed to be treated with mutual confidence.
Zoloft is a good medicine for your condition. But I am amazed you are being treated for ten years. You are supposed to be cured within two to three years with a combination of medicines, psychotherapy and meditation.
Drowsiness is more due to inactivity and depression related obsessive thoughts. I am sure you will be cured with the help of cognitive behavioral therapy.
I need more of your details. Please provide as many details as possible about your disorder, mood, family, behavior, job etc in the follow up question.
God bless you.
Dr Anand PhD
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
well thats why i would like to come off the medication. i have a very good psychologist who i love but i know that these symptoms i am having are not depression related but either from effexor or zoloft. it came on suddenly.
my depression started when i was 21 after a bad break up with a bf who was narcissistic. it brought on a lot of pain from my childhood as my parents got divorced and my dad left me when i was 8. i ended up getting severly depressed when i broke up with my bf and started on citalopram. and have been on medication since. i was diagnosed with general anxiety disorder and have separation anxiety with my mom but i am now married and live in usa and my mom lives in london and with therapy we are improving a lot. i am an only child and when my parents divorced i grew very close to my mom and she overprotected me.
i am a qualified dentist and graduated in 2009 but then got married and moved to the us and couldnt work as a dentist here. i am now studying to be a psychologist because that is my true passion in life. due to family pressures i was forced to do dentistry but didnt want to.
i have good behaviour in public, well mannered, never had a physical fight and have a very loving husband.
please can you advice what i should do about pregnancy and my medication and how i am feeling. are there any alternative therapies? and how should i come off zoloft?
my depression started when i was 21 after a bad break up with a bf who was narcissistic. it brought on a lot of pain from my childhood as my parents got divorced and my dad left me when i was 8. i ended up getting severly depressed when i broke up with my bf and started on citalopram. and have been on medication since. i was diagnosed with general anxiety disorder and have separation anxiety with my mom but i am now married and live in usa and my mom lives in london and with therapy we are improving a lot. i am an only child and when my parents divorced i grew very close to my mom and she overprotected me.
i am a qualified dentist and graduated in 2009 but then got married and moved to the us and couldnt work as a dentist here. i am now studying to be a psychologist because that is my true passion in life. due to family pressures i was forced to do dentistry but didnt want to.
i have good behaviour in public, well mannered, never had a physical fight and have a very loving husband.
please can you advice what i should do about pregnancy and my medication and how i am feeling. are there any alternative therapies? and how should i come off zoloft?
Brief Answer:
Your past lessons are positive assets and they should propel you
Detailed Answer:
Dear XXXXXXX
Thanks for the follow up query.
As you have medical knowledge about your trouble I do not have to explain them. Still I would like to clarify some general myths about depression and anxiety. Cure is much more easier if you understand them properly.
Your case not totally Post Traumatic Stress Disorder (PTSD). That means you did go through so many emotional (traumatic) events in the past. Everyone does. Positive past events teach you POSITIVE lessons. Negative past events also teach you POSITIVE lessons. There are NO negative lessons. all lessons are positive. Then why do you want to think about those negative incidents? Instead be proud and confident about those positive lessons you learnt from your life situations that drives you forward with caution and zeal. So please don't blame your past negative events as causes of your current problems. That would amount to escapism.
Secondly, clinical depression and disappointment are two. You were disappointed with life events which was never expected. The depth of emotional disappointment was a bit more for you. Disappointment also manifests symptoms exactly like depression, but unlike clinical depression, these symptoms should vanish within a short period. In my opinion you were not depressed.
Thirdly, you were diagnosed as having Generalized Anxiety Disorder. I understand. But if you look around you, almost everybody are stressed and anxious about something. Is GAD that much a problem? If you think you are suffering from GAD, depression, Aftereffects of past events etc, they tend to become obsession and haunt you whenever you are worried.
In my experience, I always advise my clients, to be free of unnecessary worries. These issues are negligible unless you feel otherwise. That should be your attitude. Such an attitude motivates you to indulge in your day to day activities more actively which helps you to 'slowly ignore' these symptoms.
If you ignore those obsessions, they slowly fail to amuse you (without your support, no mental disorder symptoms can exist).
For you my initial therapy steps would be:
1. Study psychology as a passion
2. Exercise and be active in agile games
3. Be busy with your job or hobbies or entertain yourself.
4. Once you do the above, you will automatically be "positively" tired, so that you get good sleep.
5. If you start think positively, you will be able to keep your negative obsessions away, which keeps you always energetic.
6. You are blessed with a good and caring husband. Cherish living with him and use the positive family life as a catalyst.
7. I think, if you follow these above steps, your conception related worries should vanish.
8. Believe in god. For us, he is supposed to take care of you when you are in trouble. In that case, why worry? You have limited knowledge and resources, but we believe god has every resources to cure you. Then you should believe and pray for his blessings. Thank him for whatever he gave you, tell him that you are happy and request him to keep you happy like now as always, no complaints. Such a prayer injects positive attitude.
9. Once you follow these steps, I am sure you will be able to taper zoloft, and altogether stop, of course with the advise of your psychiatrist.
Believe in god, and then believe in his abilities, then your past lessons should propel you.
God bless you.
Dr. K V Anand PhD.
Your past lessons are positive assets and they should propel you
Detailed Answer:
Dear XXXXXXX
Thanks for the follow up query.
As you have medical knowledge about your trouble I do not have to explain them. Still I would like to clarify some general myths about depression and anxiety. Cure is much more easier if you understand them properly.
Your case not totally Post Traumatic Stress Disorder (PTSD). That means you did go through so many emotional (traumatic) events in the past. Everyone does. Positive past events teach you POSITIVE lessons. Negative past events also teach you POSITIVE lessons. There are NO negative lessons. all lessons are positive. Then why do you want to think about those negative incidents? Instead be proud and confident about those positive lessons you learnt from your life situations that drives you forward with caution and zeal. So please don't blame your past negative events as causes of your current problems. That would amount to escapism.
Secondly, clinical depression and disappointment are two. You were disappointed with life events which was never expected. The depth of emotional disappointment was a bit more for you. Disappointment also manifests symptoms exactly like depression, but unlike clinical depression, these symptoms should vanish within a short period. In my opinion you were not depressed.
Thirdly, you were diagnosed as having Generalized Anxiety Disorder. I understand. But if you look around you, almost everybody are stressed and anxious about something. Is GAD that much a problem? If you think you are suffering from GAD, depression, Aftereffects of past events etc, they tend to become obsession and haunt you whenever you are worried.
In my experience, I always advise my clients, to be free of unnecessary worries. These issues are negligible unless you feel otherwise. That should be your attitude. Such an attitude motivates you to indulge in your day to day activities more actively which helps you to 'slowly ignore' these symptoms.
If you ignore those obsessions, they slowly fail to amuse you (without your support, no mental disorder symptoms can exist).
For you my initial therapy steps would be:
1. Study psychology as a passion
2. Exercise and be active in agile games
3. Be busy with your job or hobbies or entertain yourself.
4. Once you do the above, you will automatically be "positively" tired, so that you get good sleep.
5. If you start think positively, you will be able to keep your negative obsessions away, which keeps you always energetic.
6. You are blessed with a good and caring husband. Cherish living with him and use the positive family life as a catalyst.
7. I think, if you follow these above steps, your conception related worries should vanish.
8. Believe in god. For us, he is supposed to take care of you when you are in trouble. In that case, why worry? You have limited knowledge and resources, but we believe god has every resources to cure you. Then you should believe and pray for his blessings. Thank him for whatever he gave you, tell him that you are happy and request him to keep you happy like now as always, no complaints. Such a prayer injects positive attitude.
9. Once you follow these steps, I am sure you will be able to taper zoloft, and altogether stop, of course with the advise of your psychiatrist.
Believe in god, and then believe in his abilities, then your past lessons should propel you.
God bless you.
Dr. K V Anand PhD.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you so much for your encouragement. it really helps to know that im not crazy and that i have hope to get better. i am hoping to come off medication i just hope that i will be ok
Brief Answer:
You are a cured person.
Detailed Answer:
Dear XXXXXX
Thank you for your heartfelt appreciation.
I too am truly hopeful, you will be cured. Rather already cured. Mental disorder cures are available with clear understanding of the symptoms and situation.
Once we know what is anxiety, we know how to manage it. Like handicap people manage with their handicap. In our instance, anxiety is a temporary handicap.
God bless you.
Dr. K V Anand PhD
You are a cured person.
Detailed Answer:
Dear XXXXXX
Thank you for your heartfelt appreciation.
I too am truly hopeful, you will be cured. Rather already cured. Mental disorder cures are available with clear understanding of the symptoms and situation.
Once we know what is anxiety, we know how to manage it. Like handicap people manage with their handicap. In our instance, anxiety is a temporary handicap.
God bless you.
Dr. K V Anand PhD
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
but i am still having anxiety right now. how am i going to come off during this horrible time? at the same time i want to come off to concieve a baby. i keep having thoughts that my mom or someone in my family will die and feel like i am psychic and this means something is going to happen
Brief Answer:
Believe in your ability and the ultimate
Detailed Answer:
Dear
Thanks for the follow up.
Ignorance is the best method for obsessive thoughts. "I am having these negative obsessive thoughts. Fine. I know. So what ?". Should be your attitude.
Being busy suppress negative thoughts. Work keeps you physically and mentally engaged. Hobbies tranform your intellect and creativity positively. Entertainment and games keeps your mind happy and "living now". These three combines and you be busy.
Busy means no obsessions. No obsessions means no anxiety. Above busy schedule + absence of obsession and anxiety keeps you fresh and provides good sleep.
You should also practice steps which I gaveyou earlier.
Remember, cure lies in your attitude. Fight with enthusiasm, forthere are no other short cuts.
God bless you.
Dr K V Anand PhD
Believe in your ability and the ultimate
Detailed Answer:
Dear
Thanks for the follow up.
Ignorance is the best method for obsessive thoughts. "I am having these negative obsessive thoughts. Fine. I know. So what ?". Should be your attitude.
Being busy suppress negative thoughts. Work keeps you physically and mentally engaged. Hobbies tranform your intellect and creativity positively. Entertainment and games keeps your mind happy and "living now". These three combines and you be busy.
Busy means no obsessions. No obsessions means no anxiety. Above busy schedule + absence of obsession and anxiety keeps you fresh and provides good sleep.
You should also practice steps which I gaveyou earlier.
Remember, cure lies in your attitude. Fight with enthusiasm, forthere are no other short cuts.
God bless you.
Dr K V Anand PhD
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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