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Suggest Treatment For Severe Depressive Episode With Psychotic Symptoms

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Posted on Fri, 2 May 2014
Question: Simple question but next to impossible to implement, how to convince my clearly depressed, among other disorders, mother to go to a doctor. My father, her husband, is terminally ill with COPD. I live in a different state but come visit as often as i can but it continues to never be enough to ease what should be calmer experience. I obviously can't find the words myself. A nurse comes 1-2 times a week but enrollment in hospice has not commenced though we have been briefed on services. She has been treated with bipolar depression in the past until the doctor moved his practice but that has been 5+ years ago. Can you talk to her? I don't know what to do anymore. Her thinking is incoherent as when she hears a story she interprets it back to you In such a disorganized manner. She doesn't have the ability to notice her manners. She races through things without fully completing them. She will not take any form of criticism without get upset and snapping. She will mumble words that are not directed towards anyone or thing that make no sense. I don't believe she has delusions. She is 63 is there any help for us?
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Answered by Dr. Srikanth Reddy (4 hours later)
Brief Answer: Its depression with psychotic symptoms Detailed Answer: Hello, Thanks for choosing health care magic for posting your query. I have gone through your question in detail and I can understand what you are going through. Your mother seems to be suffering from Severe Depressive Episode with Psychotic symptoms. With the age at 63 years, even dementia could be a possible diagnosis which needs to be evaluated further. One thing is for sure that she will certainly require medical help and I probably require admission as well. But I understand your problem that you are not able to convince her in getting to the hospital. The best way is by proper communication and explanation. This is best done by a therapist who can talk to her, but if you cannot find anyone who can visit your home. But if that is not possible then you can try from your side. Ask her how her life was 10 years ago. And then ask her how it is now. Ask her why does she feel that things have changed? Ask her if she feels that could depression be a possibility in causing the symptoms for her? If so, then is there anything wrong in seeking help? Give her a choice of which doctor she wants to see and and at which city? You may even use a paper and pen while you are discussing these issues. Depression can occur with regular stress and it can also occur biologically without any stress as well. She will need proper treatment for the same. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or escitalopram and they are all very effective and mostly safe. She may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep. If she is averse to the drug therapies then there is also an option of cognitive behavioural therapy. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help her with her illness. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: bit.ly/dr-srikanth-reddy Wish you good health, Kind regards Dr. Srikanth Reddy M.D.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Srikanth Reddy

Psychiatrist

Practicing since :2007

Answered : 2770 Questions

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Suggest Treatment For Severe Depressive Episode With Psychotic Symptoms

Brief Answer: Its depression with psychotic symptoms Detailed Answer: Hello, Thanks for choosing health care magic for posting your query. I have gone through your question in detail and I can understand what you are going through. Your mother seems to be suffering from Severe Depressive Episode with Psychotic symptoms. With the age at 63 years, even dementia could be a possible diagnosis which needs to be evaluated further. One thing is for sure that she will certainly require medical help and I probably require admission as well. But I understand your problem that you are not able to convince her in getting to the hospital. The best way is by proper communication and explanation. This is best done by a therapist who can talk to her, but if you cannot find anyone who can visit your home. But if that is not possible then you can try from your side. Ask her how her life was 10 years ago. And then ask her how it is now. Ask her why does she feel that things have changed? Ask her if she feels that could depression be a possibility in causing the symptoms for her? If so, then is there anything wrong in seeking help? Give her a choice of which doctor she wants to see and and at which city? You may even use a paper and pen while you are discussing these issues. Depression can occur with regular stress and it can also occur biologically without any stress as well. She will need proper treatment for the same. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or escitalopram and they are all very effective and mostly safe. She may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep. If she is averse to the drug therapies then there is also an option of cognitive behavioural therapy. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help her with her illness. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: bit.ly/dr-srikanth-reddy Wish you good health, Kind regards Dr. Srikanth Reddy M.D.