Hi doctor, I am a 34 year old female. I am having a long-standing history of severe depression episodes on and off for 20 years. Despite everything, I have a degree, full-time job and home of my own. I have done really well last few years too after CBT. I have stayed well and even been promoted at work. This year I have gone off track gradually more and more though. What started as stress over work demands, turned into extreme anxiety with disabling effects. Then we found that my mother is suffering from cancer after five years of my dad's death. I had a breakdown but did not tell my family how I had been all this while. I recovered and returned to work, but I have sunk into a deep depression now. I am unable to eat. I do not want to go out or even dress. I stay in bed when I can. The last couple of weeks, I have had strong urges to harm and even kill myself. I am also so agitated at times. My thoughts go on to overdrive. I have been home this week but have to go back to work tomorrow and stress are high there. I am somehow dealing with it. I have been given some tranquilizers on top of my antidepressants, and these have helped quite a bit, but they make me sedated so not good when I am working. I feel so alone too as I cannot tell anyone this stuff. I have also been bloodletting with needles directly into a vein. It relieves pain and suicidal ideas. What can I do? My past psychiatrist has been alerted and wanted me to go to the hospital. I refused, and fortunately, he said he could not force me at present, but that could change. I just want my mind and my life back as this year has been like being tortured. My mother is going to be fine but still undergoing treatment. Sure she knows that I am not well but cannot talk about it. Why cannot I come out of this long dark tunnel and get a grip? I have attached my list of medicines for your reference. Please help.
Hello. I can understand your concerns. You should be able to distinguish between disappointment and depression. Disappointment also brings on symptoms identical to depression but they are short lived. You had multiple disappointing episodes and some of them were so deep. You feel depressed because you feel so. Many people feel depressed when their near and dear one expire. But they come back unscathed mainly because there is no other alternative. You also did the same. You came back without any problem, but you feel you are depressed. You are having antidepressants and anti-anxiety drugs. Clinical depression and anxiety are usually treated with a combination of psychiatric medicines, psychotherapy, lifestyle changes, meditation and exercise. I suggest you to get a cognitive behavior therapy. Please consult a psychologist for the same. Also kindly continue the present psychiatrist treatment.