Hello,
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
• 32 year old male.
• Known case of depression and thyroid related problem.

From your description, it is clear that you have following symptoms:
• Depression.
• fatigue.
• Poor concentration.
• frequent memory loss.
• Constipation.

All these are symptoms of depression and need attention. Apart from that, concurrently you have thyroid problem which can cause or exacerbate your depression. Depression is not always situational (because of stress). Many times it is biological due to biochemical changes in brain. Your depression appears to biological to me due to its severity.

Before prescription, physical examination and laboratory examination is needed to rule out physical causes of depression. Mental status examination is also necessary to assess severity of depression. Apart from that anti depressants are prescription drugs, so in person consultation with psychiatrist is necessary for treatment.

Following measures will help you:
• First remember your situation is transient and will solve in few weeks if you follow my advice.
• Ask help from friends and family members, do not shy for that.
• Make structured daily routine.
• Eat adequate food, fruits and drink juice. Avoid alcohol use if any.
• It is good if you work regularly but do not take much stress while working.
• Talk frequently with friends and family members.
• Get investigated and treated for thyroid problem as some of your symptoms can occur because of thyroid problem too.
• Most important visit psychiatrist so that he can counsel you and prescribe medicine for depression after assessment. Now very good medicines available for depression. People's life changes within weeks of treatment.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Please accept my answer in case you have no follow up queries.

Regards,

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Hello and thanks again,

It is good that you have good social and professional skills whenever you are well.

Regarding treatment, it appears to be well balanced to me. The current treatment given to you is effective more than 80% cases of depression; although dose adjustment may be needed further after mental status examination by treating psychiatrist.

Regarding your last problem – “I imagine something so dirty about any female or male, against which I attracted so much, but he doesn’t notice me”:- This problem can be addressed after improvement of depression, till then it is better not to think about that.

I hope this answer is informative and useful to you.

Wish you good health.

Regards

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