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The question was submitted 03/04/2008

Subject: Need advice, help, just can't get out of the rutt

Hi Depnet, firstly would like to acknowledge the effort you have put in to this site and support networks.

I'm in my mid 20's, have had depression probably since about 17 and formally diagnosed at 20. Had issues with negative attitude, assertion and social anxiety from time to time and this played a part in not completing uni even though I attained a yr 12 mark higher than 95.

I've been on and off with Cipramil since late 2002 and have only changed meds once. I've also seen counsellors and psychologists as well as a psychiatrist and even went to a social anx group therapy course.

I think alot of my anxiety is perceived, because I'm seen as quite outgoing. I think also my cognitive habits are skewed way too much to the negative side of things. The problem I've been having is a lack of motivation and drive to really make something of myself, I just seemed to have given up lately and have passed the time away.

I would have to say I'm not that strict with my meds and always forget and am really reluctant to take more than 1.5 (30mg) of cipramil tablets a day due to side effects. I also don't want to be prescribed higher doses and whatnot to try and curb things as it can't be good for my body.

I'm living at home, thankfully my family has been there and are basically keeping me afloat but I know they're worried like crazy. I resigned from my f/t job before xmas 2006 and haven't even bothered to seek employment since, to not be working for 15 mths after being employed for about 7 yrs is disgraceful.

I have many issues with perfectionism and stuff and have dug a hole for myself by not working and having structure in my life. The reason why is because i've been so disheartened, when I was working I still wasn't coping well enough with my mental health amidst normal life. I would hardly go out and socialise, always be really tired, would skip alot of days from work and not really give a crap.

So I'm really worried that will happen again, I have regretted so many years of my life that I can't get back where I could have attained a degree and travelled the world etc but I've just found it hard to fight the depression and anxiey on a consistent basis. This has caused me to not really have a close knit group of friends and I don't think I could ever have any, let alone host a party of a bbq for them.

The other thing that worries me is I'm a man. I've had r'ship breakdowns because of my own issues that flowed onto the r'ships itself and I basically have lost hope in ever being married because even though I do take care of myself somewhat no woman would want a man who isn't dependable no matter how attractive he is.

When I'm really down I do get suicidal thoughts but I've never ever harmed myself, well physically. The response from me is to just sleep it off, sometimes for 12-16 hours, and not eat etc.

I don't know what to do? Am I retarded am I different from everyone else with depression who have a life, go out, have children and are married with a house on rent or mortgage?

If you've managed to read all this then blessings to u.

Regards

Answer from DepNet

Dear Need Help,
In spite of your apparent doubts you’re no different to a lot of other people who have a less than optimal response to treatment for depression. The trick is to see if we can find any clues as to your incomplete response.

The main points are:

1. Anxiety disorders, including social phobia often exist alongside depression.

2. Many very intelligent people suffer from depression.

3. Negative cognitions can be caused by the depression but they can also become a bad habit. Ditto for fatigue, lack of motivation and avoidance. CBT and similar psychotherapies address these issues but you still need to make the effort to change them.

4. Poor compliance with medication instructions (missing doses or failing to take a sufficient dose) means you’re not giving yourself much of a chance to get better. Many people will have an inadequate response if they do this. You might not know it but your dose is determined by genetic factors NOT by how bad your depression is. A few people have to take much larger than average doses to get a decent response. You could be one of this group (after all, someone has to be in it).

5. If you have problems with side-effects you need to discuss them with your doctor. It is almost always possible to find a medication that suits. This can often require a psychiatrist since they have the luxury of more education and experience (than GP’s) with antidepressants.

6. We can all lament what we didn’t do or missed out on in the past and we can all fear how bleak the future might be since we can all loose everything at any time. It seems to me that the only important (and real) thing is the present so I’m going out to do a task I’ve been putting off for several months and I suggest you make use of your time also.

The answer was published on DepNet 07/04/2008