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Suggest Treatment For Severe Depression
Question: Suggest treatment for severe depression
Brief Answer:
You seem to be depression,antidepressant medicines or ECT are the options
Detailed Answer:
Hello Sir,
Thanks for writing to us.
There is no any other recent question regarding your mental health is found out in this query other than this, You have written, "unsuccessful CBT. I feel the need for greater intensive treatment and being under some else's control. I am periodically suicidal following the loss of my wife. From time to time I feel unsafe."
Your narration suggests you are likely suffering from severe depression.
In this case anti depressant medicines would surely help.Considering suicidal aspect Electro Convulsive Therapy(ECT) would be more useful.
Please narrate your question in detail if it is something else you want to ask.
If you have already taken any medicines/treatment apart from CBT, revert back to me with those details.
Also let me know if you have any physical problem and any medicine for the same is going on.
Hope I have answered your query,I will be happy to help further.
Regards,
Dr.Chintan Solanki.
You seem to be depression,antidepressant medicines or ECT are the options
Detailed Answer:
Hello Sir,
Thanks for writing to us.
There is no any other recent question regarding your mental health is found out in this query other than this, You have written, "unsuccessful CBT. I feel the need for greater intensive treatment and being under some else's control. I am periodically suicidal following the loss of my wife. From time to time I feel unsafe."
Your narration suggests you are likely suffering from severe depression.
In this case anti depressant medicines would surely help.Considering suicidal aspect Electro Convulsive Therapy(ECT) would be more useful.
Please narrate your question in detail if it is something else you want to ask.
If you have already taken any medicines/treatment apart from CBT, revert back to me with those details.
Also let me know if you have any physical problem and any medicine for the same is going on.
Hope I have answered your query,I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My Mental Health question was based around a Psychiatrist shortly will conclude on an 8 session assessment. He has been informed of my childhood problems which have left me sometimes Paranoid, Very Impulsive. I am retired and living alone since my dear wife died. I am sometimes suicidal and feel at times quite unsafe. Of a night I am happy to wear diapers and plastic pants as when emotional, say twice monthly I would wet the bed extensively. I would dearly love to be with my wife but being Christian I am not allowed to commit suicide. I am therefore between a rock and a hardplace. Whence I get worked up into a frenzy. Suggestions which have been made as time has gone by have been a course of ECT as an Inpatient, MBT, and Prychtherapy. At times I feel reasonably happy, but at others quite unstable. If admitted I would prefer to be prevented from walking out away from my treatment. What do you think will happen or should happen to me.
additionally, I have been diagnosed with BPD and Narcissistic traits.I also have Polymyalgia, Carpel Tunnel Syndrome, and I am having trouble with my eyes- Cataracts and Macro Degeneration. I need to play Golf which is the cornerstone of my life. Without Golf life has little meaning and I will be at high risk. I feel that I need taking in hand and given a good shaking.
My medications, 40mg Fluoxetine, 75mg Aspirin, 25mg Atenalol, 10mg Omeprazole, 20mg Provastatin, 5mg Prednisolone, 750mg Naproxen, Daily.
additionally, I have been diagnosed with BPD and Narcissistic traits.I also have Polymyalgia, Carpel Tunnel Syndrome, and I am having trouble with my eyes- Cataracts and Macro Degeneration. I need to play Golf which is the cornerstone of my life. Without Golf life has little meaning and I will be at high risk. I feel that I need taking in hand and given a good shaking.
My medications, 40mg Fluoxetine, 75mg Aspirin, 25mg Atenalol, 10mg Omeprazole, 20mg Provastatin, 5mg Prednisolone, 750mg Naproxen, Daily.
Brief Answer:
SNRI or lamotrigine can help
Detailed Answer:
Hello,
Thanks for detail information.I can understand your pain.
Being alone and taking these much medicines for different problems are too much troublesome.
BPD means either borderline personality disorder or bipolar disorder.Please clarify. I think it is bipolar disorder likely considering your history.
From psychiatry point of view you are taking fluoxetine only right now.
SNRI group of medicines(Mirtazapine, duloxetine or desvenlafaxine) can help you more. It is useful for your depression as well polymaylgia.If it is bipolar depression lamotrigine would help more in keeping mood enough happy consistently.
Supportive psychotherapy is useful.In that there is no specific sessions like CBT. You just need to discuss your feelings with the therapist. Therapist can help you in scheduling your daily activities according to your health.This can occupy your time in some work/activity and keep you happy.Search for alternative of GOLF is needed.
If problem is severe, again ECT can be given as an indoor patient.
You should consult your psychiatrist and discuss above aspects.You can be improved with treatment.
Hope this answer is helpful to you.
Regards,
Dr.Chintan solanki.
SNRI or lamotrigine can help
Detailed Answer:
Hello,
Thanks for detail information.I can understand your pain.
Being alone and taking these much medicines for different problems are too much troublesome.
BPD means either borderline personality disorder or bipolar disorder.Please clarify. I think it is bipolar disorder likely considering your history.
From psychiatry point of view you are taking fluoxetine only right now.
SNRI group of medicines(Mirtazapine, duloxetine or desvenlafaxine) can help you more. It is useful for your depression as well polymaylgia.If it is bipolar depression lamotrigine would help more in keeping mood enough happy consistently.
Supportive psychotherapy is useful.In that there is no specific sessions like CBT. You just need to discuss your feelings with the therapist. Therapist can help you in scheduling your daily activities according to your health.This can occupy your time in some work/activity and keep you happy.Search for alternative of GOLF is needed.
If problem is severe, again ECT can be given as an indoor patient.
You should consult your psychiatrist and discuss above aspects.You can be improved with treatment.
Hope this answer is helpful to you.
Regards,
Dr.Chintan solanki.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response. Mirtazapan was chosen after I had a panic attack whilst taking Fluoxetine, but it very nearly paralysed me. I was not weaned off Fluoxetine. In my case it is Borderline Personality Disorder that I suffer from. I feel that I would gain with ect I really feel that a few sessions with ECT will do me a power of good. I do not know how many sessions that I would need, or whether I would need to go back in for 'maintenance treatment' I also feel that Hospitalisation would be very good for me. Thanks you again.
Brief Answer:
Past response to ECT is good, go for it
Detailed Answer:
Hello,
Sorry for delayed response.
If mirtazapine was not suitable,desvenlafaxine is good option.It is with the least side effect profile.
Borderline personality Disorder is difficulty to treat always in most of the cases.It is really good that you are at least stable somewhat though you have BPD.
In BPD mood swings can be controlled with mood stabilizer like valproate. However prominent mood symptom in your case is depress mood.In this lamotrigine would really help I guess.
If past response was good to ECT , you should go again for ECT. In my opinion 4-5 ECT will be needed.After that depending on condition even maintenance ECT can be given.
In conclusion desvenlafaxine or lamotrigine should be added, wait for improvement for 2-3 weeks if not satisfactory improvement, ECT should be started.Or ECT can be given at first step if you do not wish to go ahead with medicines.Ultimately your treating doctor's opinion also matters.You can request him and discuss about this approach and move ahead.
Wish you early stability.
htpp://bit.ly/drchintansolanki
Past response to ECT is good, go for it
Detailed Answer:
Hello,
Sorry for delayed response.
If mirtazapine was not suitable,desvenlafaxine is good option.It is with the least side effect profile.
Borderline personality Disorder is difficulty to treat always in most of the cases.It is really good that you are at least stable somewhat though you have BPD.
In BPD mood swings can be controlled with mood stabilizer like valproate. However prominent mood symptom in your case is depress mood.In this lamotrigine would really help I guess.
If past response was good to ECT , you should go again for ECT. In my opinion 4-5 ECT will be needed.After that depending on condition even maintenance ECT can be given.
In conclusion desvenlafaxine or lamotrigine should be added, wait for improvement for 2-3 weeks if not satisfactory improvement, ECT should be started.Or ECT can be given at first step if you do not wish to go ahead with medicines.Ultimately your treating doctor's opinion also matters.You can request him and discuss about this approach and move ahead.
Wish you early stability.
htpp://bit.ly/drchintansolanki
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Above answer was peer-reviewed by :
Dr. Shanthi.E
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