The question was submitted
29/01/2008
Subject: Re:Depression Anxiety Causes and Treatment
I'm a 29yo Male who has always lived in Adelaide, about 1 year ago I moved back to my parents house after living with a friend and his girlfriend for four years. I had fairly severe depression when I was 20-21y.o. which came about after my breakup with my first long term girlfriend. I saw a Psychologist for about 2-3years and during this time was prescribed by a doctor firstly Zoloft (didn't work for me) then Cipramil (Worked well for me). I took Cipramil for 2-3 years and then stopped once I felt better and was more stable with a permanent job I previously had never had. I was going along fine until suffering a rather strange virus style illness last November(2007) this brought on severe anxiety/panic attacks and reignited my depression. I am currently taking Cipramil which started at 20mg (the dose I had several years ago)but this has done little to ease the depression though has had some effect on the panic attacks which are now way less severe. The doctor has suggested 40mg Talohexal which I believe is the same as Cipramil so I am currently on 30mg Cipramil until this runs out. I haven't been able to see a Psychologist since I became concerned in November and I'm still waiting, I think this hasn't helped as a GP doesn't have the time to listen to my stories.
At some stage last year I was wrongly diagnosed as having a staph infection and treated with fairly strong antibiotics it turned out it was a fungal infection. I have been reading up on causes of depression and psycho-motor disturbance and have found that parasitic and viral infections can cause depressive symptoms. Does anyone know whether this might be true and how these possibilities can be investigated?
Answer from DepNet
In the majority of cases, there is no identifiable cause for depression. There are known risk factors for the condition, such as bereavement, a family history of depression, stroke, thyroid disease, alcohol or substance use, but not everyone who has these risk factors develops depression. Moreover, some individuals develop depression in the absence of identifiable risk factors. There are clearly factors that prevent some individuals from developing depression, even when one or more risk factors are present.
It is true that some individuals may develop depressive symptoms in the context of infective diseases, but it should be remembered that again, development of depression is not inevitable. Even when an individual develops some symptoms that overlap with symptoms seen in depression, this is not the same as saying they have a syndrome of depression.
In cases of depression due to medical conditions (including those due to infectious diseases), it is necessary to treat the underlying condition. In many cases, the depressive symptoms resolve when the underlying condition is treated.
If you think you have an undiagnosed or untreated infectious disease, I would advise consulting your medical practitioner about this. In your case, however, you do have risk factors for depression, including a prior episode some nine years ago. This does make it less likely that your current condition is due to a medical condition, and more likely that it is a recurrence of your depressive disorder.
I am unclear as to why you are on citalopram (Cipramil) 30 mg daily when your doctor has recommended you increase the dose to 40 mg daily (Talohexal = citalopram). I would advise taking the citalopram at the dose suggested by your doctor, and informing him or her when you changed the dose. It's important for them to know exactly what dose and when you have been taking it, so they can calculate the expected response, and adjust the dose accordingly.
I hope this helps.
The answer was published on DepNet
01/02/2008