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Suggest treatment for suicidal thoughts and depression

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Psychiatrist
Practicing since : 2005
Answered : 637 Questions
Question
I has partial numbness in right side of my face and MRI showed lesions in brain and spinal cord. I was diagnosed with "acquired white matter disease - Sjogren's syndrome - B12 & Vit D deficiency). I am on mycophenolate for past one year. Since last november I am very depressed and have recurring suicidal thoughts. I quit 2 jobs in last six months. Now I am to start a new job in two days. I m very anixious and my suicidal thoughts have increased a lot and i m strangling myself till i cant breathe - after which i feel little calmed down. I am now very scared to start a new job. I m talking well with others - but suicidal thoughts are there in the background. Are my medications/existing medical condition causing this or is this result of some undiagnosed psychiatric condition. In addition kindly advice on the specialist I should consult. Thank you.
Posted Sat, 30 Aug 2014 in Anxiety and Stress
 
 
Answered by Dr. Sunil Gupta 19 minutes later
Brief Answer:
Please see details below.

Detailed Answer:
Dear Ms. XXXXXXX

I went through your query in detail and can understand your concern. The symptoms that you have mentioned are highly likely to be due to depression. Feeling sad, suicidal thoughts, decreased self confidence, anxiety are all manifestations of depression. Since you are also having suicidal thoughts, I would consider the severity of depression to be high.

In your case, depression can exist as an independent condition as well as due to medications or Sjogren's syndrome. Both Mycophenolate as well as Sjogren's syndrome has been associated with depression. In case your depressive symtoms started soon after starting Mycophenolate, it is probable that mycophenolate might be responsible.

You should consult your rheumatologist and get evaluated by a psychiatrist as well. In your case, I would recommend adding an anti-depressant like venlafaxine or escitalopram at the earliest. Change in any medications for Sjogren's would not be advisable as it seems you have been responding well to mycophenolate for the same. Change in Mycophenolate should only be considered only if you do not respond to the anti-depressant therapy.

I do hope that I was able to answer your query. Please feel free to ask any further query that you may have. I will be glad to offer help.

Best wishes for a speedy recovery,

Dr. Sunil Gupta



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