Suggest Treatment For Severe Depression And Anxiety
Do not score well in depression and anxiety part, cognitive tests not bad.
Detailed Answer:
I read your question and reviewed that report you provide.
There are several neuropsychological tests evaluating your cognitive functions as well as some tests aimed at evaluating depression, anxiety and sleep.
Most tests results are given in Raw and T column. The Raw are the actual points you score, while T means T score, which is more significant as it shows where you stand in comparison to other people of your same group (similar age, sex etc). So if you are at a T score of 50 it means that you score as the average person of your age scores. Values over 50 are better than average, if under means lower than average. Usually values of +/- 10 (40-60) are considered average, it's more than that which has any significance.
So judging from your T score values things do not look bad, for the most part you score inside the average, often even better.
Where you seem to not do well though is in the sections evaluating depression, anxiety and sleep which indicate that you have considerable anxiety and depression issues which should be addressed.
I remain at your disposal for other questions.
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Detailed Answer:
Thank you for the additional information. I understand the difficult situation you are in. I also understand the neurologists as CADASIL is a frustrating condition as there really is no known cure, one can only try to cope with the symptoms as they come. However I still find unacceptable for them not to see you - I guess that's the US system, one can't choose his patients where I live. I am afraid I am not aware of finding a way around that though, you should discuss with your primary physician about what other possibilities the system offers, perhaps a psychiatrist may also be able to help you.
Your remarks about the care needed with medications which can have side effects on central nervous system are correct, one must search a balance between addressing symptoms and avoiding cognitive side effects.
CBD should be continued. In terms of medications I am afraid antidepressants are the most suitable ones. I do not know which ones you have tried. The most recommended are the SSRI group like citalopram, starting by the smallest dose and increasing gradually if needed.