Hi Lem Wow PHd, one very high flyer -I'm well impressed! but sadly mental illness can afflict us all. Sorry you are having a crap time, but in a way it's a good thing that you know the root cause of your dep/anx. You mention that you are in awe of Vicar being able to look for jobs, when you can't contemplate that. The reason is very clear Lem - Vicar is no longer depressed (she was when she started the thread and I'm sure she will confirm this) and that's why she has the emotional strength that you don't have just now, but you will get better though it is going to take time and the right dose of meds. 4 out of 5 people recover from depression within 4 to 6 months, especially if it is a first eposide. I think when we are in the midst of the grey fog of depression we are in awe of anyone doing things that we could have done without a second thought when we were well. The thing that got me to the GP in my first episode was the increduality I experienced when hearing a colleague discussing baking a birthday cake with her sister, for their mother's 70th birthday (and I can make birthday cakes!!) which made it even more wierd.
I did think your expectations about the weekend were a bit on the high side to be honest. The thing is with dep/anx you have to learn to "take each day as it comes" as they can (as you have discovered) fluctuate from day to day and your mood can change through the day. I think you said mornings were the worst (same here) and you lifted through the day sometimes. That is my pattern too, but my dep is intermittent as I outlined in a long post.
You asked about referral to a psychiatrist. Referrals are made to consultants, on the basis of clinical need, be it mental or physical illness. However with physical illness, there are tests that can be carried out at the primary care stage, x-rays, blood tests, scans etc. but there are no such tests for depression and anxiety, nor for any of the other types of mental illness, as far as I am aware.
I was recently told by my CPN (who I still see on a monthly basis) that there were now strict demarcation lines about which "track" a patient would be on. Again like so many things, it was the "numbers game." She explained that if you scored below 4, you were on the primary care route GP and mental health nurses attached to the practice. If above 4 you were on the CPN/ConsltPysch track. As she assured me I was above 4 I didn't get around to asking her what the questions were, as I assume this is what she meant. This is obviously something that has been set up in my area. I am above 4 because of my psychiatric history and 2 admissions to a pysch ward.
To be honest Lem with a first episode of depression and on 20mg citalopram, I don't think any GP would perceive there was a clinical need to refer you to a psychiatrist. He/she is more likely I would think to increase the dose to see if that has a good effect. Sorry I can't recall how long you have been on them, but don't think it's that long. Recovery from depression is a slow process and so you have to be a bit patient with yourself, though I know you are worried about money. Is there any chance you could re-mortgage or take out a loan with the bank to tide you over till you are better. I think you really need to look into that because worrying about finance could make you more anxious, and so slow down your recovery.
SO I reckon your first step is back to the GP and see where you go from there. I can recall MNs on other threads talking about the good effect of raising the dose of citalopram, and they do usually start you off on a low dose.
Miggsy where are you. We are all here and caring about you.
Hooch ditto
You are both suffering a lot, please come back and talk to us.
Please don't be put off by everyone seeming to know everyone, and the last few posts all about Vicar - I suppose she is the "Head girl" (not you understand that she has made any such reference to that herself) I just thought of it on the spur of the moment. Vicar started the original thread and this is the 4th edition.