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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Severe Depression And Anxiety Be Treated?

I feel more comfortable asking about this here, I feel like people won t take me seriously or believe me, I m scared of judgement. I have known for six years (I am now 19) that I have diagnosed depression, and anxiety. However as I ve gotten older my symptoms have changed and I feel like I m not sure my diagnosis specifically suits me anymore. I want to ask what form of depression I have since this was never discussed with me. Also any possibilities of another mental disorder that may make more sense to my situation? A summary of how I feel majority of the time would probably be hopeless, suicidal, depressed, lacking energy, anxious, and tired, I feel a loss of reality, I don t feel real and often feel as if I am just walking through a dream. I sometimes (more recently but also occurring over time) have been experiencing hallucinations, paranoia and imagining things that aren t there. For example I see things that aren t there, hear things that aren t there, I have heard voices that have told me to do things, and this often results in panic attacks and I feel embarrassed and ashamed because I know it isn t real. Aside from mostly feeling severely depressed, I sometimes (rarely like once a month) feel elated, I gain motivation and I ll tackle everything in life that I ve felt too depressed to do. I impulsively do things that may be reckless (drink excessively, take drugs, make large life choices etc.) I feel confident which I never feel, I feel somewhat superior and better than others. I take care of my hygiene excessively which I don t do often, I decide things like that I am going to go to university and move out and during my last phase like this I quit my job to pursue my dreams. I impulse buy items which I later regret and feel irritable. This usually doesn t last long (usually for like a day) and then the next day I go back to my usual depressed self, somewhat more depressed and feel a sense of disappointment and guilt for not following up on the things I vowed to do, and hate myself for losing motivation. Sometimes I self harm in the form of cutting. When I feel high I still don t really feel happy, it feels false and I get energy but I don t believe I feel happy. More erratic, unstable etc. please if you could help with a diagnosis (formal or not) it would be much appreciated in assisting me with a better suited approach. I have also been on anti depressants for 6 years. Thank you in advanced.
Mon, 24 Apr 2017
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General & Family Physician 's  Response
Hi. I can uderstand that this is a big concern for you.
The symptoms you are describing that you feel most of the time are typical of major depressive disorder. The hearing, seeing and believing things, paranoia are psychotic symptoms which in some cases can happen when then depressive episode is severe.
Then you describe symptoms that can fit a manic episode, but for bipolar disorder these symptoms have to be at least present for longer than 4 days in a row.
Did you experience any childhood trauma or abuse?
This could lead to depersonilization (dont feel real, in a dream) or can shape your personality in a way that you self harm, have mood swings etc
I hope I could give you a better understanding
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How Can Severe Depression And Anxiety Be Treated?

Hi. I can uderstand that this is a big concern for you. The symptoms you are describing that you feel most of the time are typical of major depressive disorder. The hearing, seeing and believing things, paranoia are psychotic symptoms which in some cases can happen when then depressive episode is severe. Then you describe symptoms that can fit a manic episode, but for bipolar disorder these symptoms have to be at least present for longer than 4 days in a row. Did you experience any childhood trauma or abuse? This could lead to depersonilization (dont feel real, in a dream) or can shape your personality in a way that you self harm, have mood swings etc I hope I could give you a better understanding