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Suggest Treatment For Mixed Depression And Anxiety

Posted on Fri, 28 Mar 2014

Question: Hi, I have had lots of personal problems.my husband left home and went missing for 5 days asking my family to clear dues. This is the fifth time that this has happened. I have been married for 20 yrs. now. I have led XXXXXXX traumatised life all the 20 yrs. since he left home in august my family have took me home and have not gone back since. I have from 2 yrs seeked counselling and have been clearly told that my questions need to be answered. and my anxiety will come down. after august the doctors gave me dulot and quitpin. I had panic anxiety attacks after he left home.the doctors I don't know why asked me to change consultation. they kind of said that they are sorry I don't know why. today I went to another doctor for counselling she said that my thoughts are racing may be there's mild depression. she asked me to check my thyroid levels and gave me oleanz plus for 10 days and asked me to see her after 10 days. My husband has got away with all that he did to me for 20 yrs. And how should I not be angry or cry or be upset about it. How will these medications help. now that I am away from him life is easier financially emotionally and every way. why medication and how do you stop thinking about what has happened all these yrs with oneself. I have moved out of my parents place ,am into some work or other .people some how seem to distance themselves .

Answered by Dr. Vivek Chail (2 hours later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi, Thanks for writing in to us. I have read through your query in detail. It appears that you have suffered a lot through the years but please do not lose hope. You might be having mixed depression and anxiety. The medication oleanz plus contains olanzapine 10 mg and fluoxetine 20 mg. As you do not have psychosis you may take only fluoxetine which is an antidepressant. Duloxetine is also an antidepressant but somehow did not work in you. Fluoxetine must be taken for atleast 15 days for improvement and needs to be continued for at least 6 months. A thyroid evaluation is also necessary to rule out thyroid dysfunction. Also please get your complete psychiatric clinical examination done. Wishing you good health. Hope your query is answered. Regards, Dr.Vivek

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (19 minutes later)

Dr, Now that I have completely cut off from my husband and am seeing a lawyer for divorce. And my family and his friends too are helping me I think automatically my problems will resolve and slowly the anxiety will come down. It already has don't I just need time to heal the hurt snd loss than give names as depression psychosis and so on. I went for counselling to stop the previous medication and I get another medication.

Answered by Dr. Vivek Chail (13 hours later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi, Thanks for writing back with an update. Glad to know that you are ready to make certain changes to your life and that you have relatives and friends supporting you. If you believe that your anxiety is improving each day then surely you will be free from your problems very soon. Mental health is a wide spectrum of human behavior and terms like anxiety, depression and psychosis have to be used after careful clinical examination. It is not good to give names like depression and psychosis without knowing completely what is going on in a patient's mind. Counseling is best taken from a psychiatrist or clinical psychologist. There are methods in counseling which need to be used sequentially. You may express your thoughts in detail and also mention that if possible you want treatment without medications. However medications in very low doses might be required to treat your anxiety faster than only counseling. Wishing you good health. Hope your query is answered. Regards, Dr.Vivek

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (40 hours later)

Thank you doctor, This reply is giving me some relief. But who does the evaluation. The doctor before suggesting medication should do an complete evaluation. When there are problems in life isnt it normal to feel devastated? When a person is angry due to prolonged abuse isnt it normal to shiw symptoms of depression. Why is it that being sad upset angry etc at these situations considered as problems. They are normal behaviour when in a difficult situation.

Answered by Dr. Vivek Chail (8 hours later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi, Thanks for writing back with an update. I agree with you that the normal mental health of a person varies as per situation from happy to sad and angry. As long your being sad or upset do not affect your normal daily activities and social interaction it is normal. Once you start isolating yourself and not being able to keep up with your daily routine, then you need help in the form of counseling or medications. The earlier you seek help the better i t is. Many people like you try to fight their problems alone but you are your best judge if you need more help to come out of your situation. You must try meditation and other stress relieving activities. The evaluation is done by a psychologist and psychiatrist together. The solution may not be found in one session but make take some time and after performing certain psychological tests. Wishing you good health. Hope your query is answered. Regards, Dr.Vivek

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar