Where is the line between cheesed off a bit and depression?

[mawbroon]

I am wondering if I am depressed.

I suffered my first ever bout of psychosis in early December which was a big shock for me and my family. My psychiatrist warned me about post psychotic depression and to be on the lookout for suicidal thoughts and the like. I am certainly not anything like that, but I do wonder where feeling pissed off starts to become depression rather than just a bad day.

My mood goes up and down, but mostly I feel a bit down. I don't laugh much and am finding that I am not really enjoying my kids like I used to. Every little thing feels like a big effort, even having a shower or cooking dinner. I am on anti psychotic medication which knocks me out, so I have very little by way of child free time in the evenings because I have to go to bed early.

I am trying to go for a walk most days, but again it is a huge effort and seems a bit pointless unless I am actually walking somewhere to do something. I try to have some sort of appointment each day, even if it's just with a neighbour for a cup of tea, to get me out of the house. If I don't have anything to do, then I come back from the school run and sit down and nothing gets done other than the very basics. If I didn't have ds2 to look after, i would probably go back to bed tbh. DS2 is 2yo and he is the cutest chilled out wee thing every and I used to look at him and get a warm glow, but now I look at him and wish he was around age 4 when things get a bit easier - and he's not even a difficult toddler. I can't face taking him anywhere like soft play or swimming, so he just pootles around quite happliy at home.

I have just read this back and I think I do sound a bit depressed. I am very against going on to anti depressants, but I have no idea why I feel that way.

Does anybody have any words of wisdom for me?

I think you should speak to the GP. I went on ADs for a year. I felt like you and went to the GP and filled in the questionnaire and talk about how I felt etc. I saw her every fortnight to begin with and then every 8 weeks whilst on them and regularly re-completed the questionnaire and then I came off them slowly whilst seeing the GP regularly when ready and my score was good. It sounds like a faff but when properly monitored and supported they truly are fantastic. I felt like a new person and wondered exactly how long I'd been depressed after they began to work (about 4 weeks).

Thanks Teaandcakeplease. I was at the GP for more meds last week and I mentioned it to him and he said he could give me ADs if the St John's Wort that I am taking doesn't make any difference.

I kind of want to wait until I see the psychiatrist again rather than get ADs from the GP, but again, I don't really know why I feel this way.

Makes sense, if it gives you more joined up care by speaking to the Psychiatrist whose already treating you.

This is a new psychiatrist. I got signed off the intensive team a few weeks ago and have my first appointment with new guy in 6 weeks time. It does seem a while to struggle on though. hmm, might go to GP, oh, I dunno.

I would call it depression when you get no feeling from the things that you do normally enjoy.

For me its walking the dog, doesn't matter what the weather like, or how busy I am - usually once I get out with the dog - I realise how lucky I am to live in such a beautiful place. When I find I'm just dragging myslef along and could'nt give a shit - then its depression in my book.

As other posters have said - see GP for possible A/ds

6 weeks is a reasonable amount of time to try the simpler things... sunlight between 11-2, omega 3 vitamins, and a bit of exercise (take your wee boy to the park every day "for his sake" if you're like me and can get motivated for others but not yourself maybe?) are all supposed to help. How long have you been feeling like this/taking the St John's Wort? Is it at all possible that this is a side effect from the meds you're on, or a result of the combo of St John's Wort and the other stuff?

I've only been on the St John's Wort for around 10 days. I decided to give it a try because of the way I have been feeling. I don't know how long you have to take it to notice the effects, probably for longer than I have at the moment.

The daylight and exercise stuff does definitely make a difference, but even when I do manage to keep it up, I still don't feel normal. This has been since January when I started feeling a bit more "normal" after the psychosis.

2 to 6 weeks is how long it takes things to affect your brain chemistry, but I don't know specifically how long st johns sort would take (that one scares me like ADs so I never looked into it). Ask your herbalist?

Else yeah, go to the gp for help in the sohrt term, he/she might be able to consult your new psych so you still have joined up care.

I found that SJW did nothing for me and I was better of on ad's - there are loads of different ones, so sometimes they needed changing or doses adjusting, but there are more options.

I know others have found SJW worked really well for them. I agree with everyone else about the lack of joy and the sort of bleak outlook you get with depression as opposed to being pissed off for a while.

I promise I'm not trying to sound patronising, but make sure you eat regularly, if I am getting on the depression slide, continuous low blood sugar from lack of food can really cloud how I am feeling.

It is so up and down. Yesterday morning, I felt ok(ish) then one little thing went wrong and it tipped me over into feeling bad and I was all set to go to the doc for ADs.

But today I feel ok again. Seems like the slightest thing can make me feel down.

mawbroon, I know where you're coming from about the up-and-down feelings! In the morning, I might be feeling happy and normal, and then in the afternoon want to do something stupid hurt myself or someone else for the LOLs and not because I'm actually mad at them or anything then be more or less ok fragile feeling, iyswim? in the evening and the next day. I've only just started on the ADs, hopefully they'll help me (and you if you go down that route. Or the SJW- give it a couple more days if you can't call the GP?)

Not been too up and down today, but kept busy....

I have made a docs appointment for tomorrow. I am so fed up of feeling shit

Good. Let me know how it goes. The hardest part is booking it and going tbh.

Well, I came away from the GP feeling that she didn't have a clue what to do! Not very reassuring. But I've got anti depressants to try. Today is sunny, so I feel a bit better about things....

Sorry the gp wasn't helpful, good luck with the ADs. Hopefully they will help between now and your next psych apt.

I don't know if it's the ADs already or not, but I have had two good days in a row and so far today feel good.

Fingers crossed

Mawbroom - Depression does ebb and flow - good days and then crap ones and some in between. Afraid it's the nature of the beast. I am still not fully recovered from a major episode 2 years ago - mostly I am fine, but it has been a long journey but even now I can get a bad day just thrown at me without reason. Glad you are trying ADs. Why did you feel the GP didn't have a clue - I know some of them don't so make sure you don't see her again.

I think your description of how you feel sounds exactly like depression. For me it is not so much feeling sad or whatever, it is the absence of any feeling, a flat, empty feeling and no interest in anything.

Do you mind saying anything about your psychotic episode. I know that people with very severe depression can have a psychotic episode but didn't know it could happen the other way round. Do you know the cause of your psychotic episode. Was just wondering if the same cause was the reason for your depression. Sorry if I am being too intrusive.

Hi NinaNana - yes, I am finding out that it's up and down. Today is a medium day I think. I am going to start keeping a diary I think just so I can have something solid to report to the psychiatrist when I next go. I can imagine if I go there on a good day I would be all like "oh yes, everything is great" which is not really the truth.

I felt the GP didn't know which drugs to prescribe because of the psychosis. She read the referral letter from the psychiatrist and mentioned that it would have been helpful if it had told her what to do. And she kept asking me "is that ok" about the drugs, but in a way that made her seem very hesitant. The drug she gave me has to be used with caution for psychosis, so I wonder if the psychiatrist will swap me on to something else.

I don't really know what caused the psychosis. The psychiatrist seemed sure it was because ds1 was unwell, but I am not so sure. I think it was a complicated combination of all sorts of things rather than just the one reason. I didn't think that I had suffered depression before, but I do recognise some of these feelings, so perhaps I have been living with depression for a long time without even knowing it.

I think it's a really good idea to keep a diary. I have done so for the past 2 years. I score every day (not in numbers) but I have categories VGD, (very good day) RGD (reasonably good day) NG/NB (not good not bad) NG (not good) NG +++ (pretty awful) sometimes a.m. NG - improved later so would score that RGD.

I only make an entry if I have anything other than a VGD. I write about how I am feeling on bad days, and this in itself helps a bit because I can moan to my diary to take the pressure off DH a bit. Sometimes the entries are big scrawls all across the page when I am at my wits end.

At the back of the diary (which is a Sainsbury's pad of A4 - so nothing fancy) I write down all the dates in the month and score them as above and then I can add up how many VGDs RGDs etc. I can then convert the figures into a % (very easy on a calculator) and see what % have been VGD or RGD days. It has been very satisfying for me to see the %s of VGDs or RGDS climb steadily through the months.... then I add three months together so for Jan/Feb/March 2011 I had 66% good days, and this climbed through last year to 70%, 75% 80% and Jan/Feb/March will be 93% good if last few days of March are OK. The psychiatrist came every 3 months and he was not an empathetic person at all, not rude or anything, just detached. So to be able to just give him a % on a quarterly basis suited him very well. Mind he did increase my dose of meds which did seem to make an improvement.

I am still aiming for 100% !!

Re the GP. I honestly don't think many GPs know a great deal about mental health, especially the older ones, as there was very little teaching on mental health issues, and some of the new drugs were not available when many GPs did their training. To be fair to her, it is usual for a psychiatrist's letter to recommend a particular med and the dosage. This is what psychiatrists do, diagnose and treat. What has she prescribed for you and what dosage, and did she warn that they can take between 2 and 4 weeks to kick in though most people get some relief after about 2 weeks.

Well, these four good days lulled me into a false sense of security. It's been crap again.]

I just don't feel anything inside .

Oh love I so know those days of not feeling anything inside. Depression is an absence of emotion isn't it - flat, empty, no interest etc but good days will return, but this up and down business is so so crap. I used to hate seeing people chatting or laughing when I felt like this.

Do you have an H or P and if so is he sympathetic, or RL friends/rels who can care for your 2yr old. On days like this, you have to try to get by in chunks of 15 mins at a time - it's too awful to see the day stretching before you. On these bad days (that incidentally the medics call "blips") do you improve later in the day or not. Mornings are worse for me with slight improvement in evening,but for some it is the other way round.

It is very early days for you - and ADs can sometimes make you feel worse for a while before you feel the benefit. What are y ou on and what is the dosage. Hope you are still taking ADs - they do take 2 - 4 weeks to kick in but you have just had 4 good days, so hang on in there and the good days will come back...........sending warm wishes........NNx

Thanks NN, yes I am still taking the ADs. It's been 13 days now, so hopefully things will start happening soon. It is called Lofepramine and I am on the lowest dose, so presuamably plenty scope for increasing the dose if this doesn't work. I am still taking the anti psychotic meds too. Apparently I have to take them for up to 2 years.

I am having an ok day so far today. I have decided not to be too hard on myself and if things don't get done, they don't get done. I think I am expecting to blitz the housework on good days, and it just doesn't seem to work like that. My days do fluctuate, but it seems that they only go downwards. I haven't had a day where i start off feeling down and then pick up, it's always the other way round. If I am feeling a bit fragile, the slightest little thing going wrong can make me cry and it seems that if I cry, then the rest of the day is spent on a downer.

I do have help with the dcs. DS1 is on Easter holidays from school just now, so a break from the school run etc is very welcome! He's been at a sleepover with his cousins and is still there which, come to think of it, is probably why I feel ok today. He constantly annoys ds2 and sometimes that really gets me down.

Very good idea not to be too hard on yourself - the housework can wait - sounds like you are the opposite way to me, better in the mornings and sometimes go downhill later in day. Ah yes I know about the crying, but that usually helps me a bit even though it gives me a headache. Sounds like it doesn't work like that for you. This is another trick that depression plays on us, everyone experiences it differently, and meds work differently on different people.

Yes I can imagine how difficult it is having to cope with the boys when you probably want to curl up under the duvet. Hope the meds kick in soon.