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Treatment for severe depression with IBS

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Practicing since : 2007
Answered : 2770 Questions
Hello, I need answers Please! I am in the pursuit of proving how extreme my PTSD is at this point in my life, I am trying to get my SSDI case won. At this point I am completely fearful of driving and large crowds at malls grocery stores as well as getting into a car. Noises and environmental things really gives me major anxiety. I am 52 yrs old, 5'8", 132 lbs. A little more about me, I have been a mother of 6 children, and work for approx. 18 years since my youngest was 2 yrs old. I have had 5 rapes in my lifetime (which I believe the last one in 2006 pushed me over the edge and my Fibro flared to the extreme and hasn't stopped since)., and seen many counselors, psychologists over the years. I always ended up putting on a brave face and getting done what needed to be done. In 2008 (I had no more control of it) my body and mind totally gave up and fell apart on me and I was sleeping 22 hrs a day for 2 years. I had been diagnosed by Social Security doctor as well as other doctors in my past (seems that I never really got healing though). My eating habits tend to reflect my depression (I lose weight quickly and that depresses me further). I have loss of vision at times, brain fog,confusion, and short term memory loss. I m sorry, I believe there may have been some confusion. I thought you had the ability to view the listed medications and health issues as well as Allergies. So, that said, are you able better to give me a more thorough evaluation, direction, and potential diagnosis as well as prognosis (this has been going on for years, and cant seem to get anything "clearly put"). 1) Current Medications; Xanax (@bedtime 0.25mg), Cymbalta (60 mg am), Hydrocodone (every 4 hrs), Allergy meds, Vit E, Multi Vit, Calcium, Omeprozole, Phenegran, 2) Diagnosis's of; Anxiety Disorder, PTSD, Fibromyalgia (SEVERE body and joint PAIN), CFS, Migraines everyday of my life.,Hiatal Hernia, Irritable Bowel and Bladder issues. Anaphylactic, Shingles. 3) I AM under a Doctors care to "manage" Fibromyalgia "symptoms" 4) Currently NOT under a Psychologist or Psychiatrist. Been through ALOT of counselors and therapist in the past years prior to 2007. 5) HAVE had a diagnosis in the past that states I am NOT Bipolar. 6) Ive had arthroscope on both knees, Radical Hysterectomy, broken both feet separately, 7)Allergies to ; Penicillin, Ibuprofen I so desperately would like to hear a diagnosis , or what my outcome or plan should be as well as a prognosis??? Thank you sincerely, L XXXXXXX
Posted Sat, 22 Mar 2014 in Anxiety and Stress
Answered by Dr. Srikanth Reddy 4 hours later
Brief Answer: Severe Depressive Episode Detailed Answer: Hello, Thanks for choosing health care magic for posting your query. I have gone through your question in detail and I can understand what you are going through. From your question it is clear that your symptoms belong to the following domains of neurotic disorder: 1. Depressive Symptoms 2. Anxiety Symptoms 3. Somatic Symptoms 4. Digestive symptoms 5. Problems with sleep. And along with these neurotic domains you have certain medical issues like irritable bowel syndrome, hiatus hernia, shingles, and anaphylaxis. Also further it appears that all these illnesses have significantly effected your current quality of life and definitely led to a lot of disability. The probable diagnosis is Severe Depressive Episode without psychotic symptoms with Melancholia specifier. Now persons with this diagnosis have frequent anxiety issues, somatic symptoms, digestive symptoms and sleep problems. But the treatment of depression can take care of this illness. Cymbalta is a good drug but you should be ideally on one of the first line antidepressants such as fluoxetine, or escitalopram or venlafaxine. Venlafaxine would be my first choice considering your symptoms profile. Normally it should be started on 37.5 mg and then gradually increased to 225 mg of 295mg. As this drug acts on nor-epinephrine and serotonine neurotransmitters it can take care of the depression and anxiety symptoms as well. You have plenty of traumatic events in your life and that predisposes you to symptoms of post traumatic stress disorder. So along with the drugs you may require Cognitive behavioural therapy and EMDR as well. EMDR is eye movement desensitization reaction - a new therapy for PTSD and done by trained EMDR therapist only. It involves repeated movement of eyeballs while you are being asked to focus on the troubling thoughts. All said the prognosis of the illnesses is not good but taking treatment is essential to improve your way of living and quality of life. You have got children to take care of and improvement in symptoms will certainly help you dealing with the family pressures. You also need to discuss with your physician about the treatments for irritable bowel syndrome, shingles and hiatus hernia. Ones your depression is controlled, you can be better motivated to seek medical help for your other medications conditions as well. The lawyers may be helpful to guide you with obtaining the disability benefit. You have sufficient paper work to document plenty of diagnoses and also the disability is very significant and very apparent. So I think that should be OK. But the law of land differs from country to country. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: Wish you good health, Kind regards Dr. Srikanth Reddy M.D.
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