To what extent are anti-d's supposed to help with reactive depression?

[ShmooBooMoo]

Okay, so... I am depressed because I am ill. I don't think I have 'clinical' depression (don't know if that makes sense...I'm trying to say I'm not intrinsically depressed, but depressed because of my health situation which I cannot change). I also have extreme anxiety (have meds for that but doc really wants me to try to get off them, so the anti-d is, in part, to help my overall mental health enough to taper off the anxiety meds, I think).

My doc tried me with several anti-d's and we settled on Lustral (Sertraline) 50mg. I checked in with her two months on as requested and told her it hadn't helped physical symptoms of my condition (she said it might) or much at all with depression (neg thinking, low mood etc).
So, if I say I'm probably negligibly better (depression-wise) will she up the anti-d again? Or, suggest experimenting more with other anti-d's.

I can't change my condition and my depression results from that. If I am having a dreadfully bad day with pain etc or get any extra stress, hormonal fluctuations eg period, the spiral of negative thinking starts and snowballs. Are anti-d's supposed to regulate mood/ keep mood even despite your circumstances? I do have 'better' days but it's not consistent (depression seems to tally with pain, anxiety, the stress of having to deal with something I find very difficult etc)

So, not sure what to say. I don't want to give doc a false impression of how much it's helping - or not - but I can't face experimenting with lots of meds! Some I tried before this one made things significantly worse but doc wanted me to persist as that can happen (so, mentally, I felt even worse during those times). Lustral has been the best but I don't know if it's really helping.

Are anti-d's supposed to help with reactive depression... I mean the situation is not going away, could get worse...so, how are meds supposed to help that? What should I say? Are anti-d's helpful in my case (I've been on 50mg for 2 months and have now been on 100mg for the same)...

Thanks!

[ShmooBooMoo]

Oops, sorry, should have said after 2 months of 50mg I had my dose upped to 100mg in the hopes it would help.

[Criminy]

I'm really no expert, not at all, but I think if the issue is something like dealing with chronic pain then a talking therapy would probably work best. I go to the pain management clinic and they have psychologists associated with them, the pain consultant can refer you to them. They're supposed to be great for teaching you coping techniques.

What about support groups for people with your condition/issues? You could Google, search on Facebook and ask your medical team for details of local ones.

Have they tried a tricyclic like amitriptyline? I only ask because that can help with the pain as well as the depression.

[MajesticWhine]

Good point there amitriptyline can be good for some types of chronic pain.

I suspect that depression due to life events might not respond as well to anti-Ds but I am not sure of the research in this area (I will look it up). I also suspect that many doctors will not really distinguish between the two, and it might be quite difficult to do so. One persons very difficult life event resulting in depression might not cause depression in another person so your condition is still personal to you, your history, beliefs, personality and brain chemistry.

The loss of your health is a bit like a bereavement and should perhaps be treated as such from a medical perspective. Time to adjust can help, as can psychotherapy. Also mindfulness is helpful for both recurrent depression and chronic health conditions.