Apparently I'm not severely depressed?

[Psion]

My CPN mentioned today that they don't consider me severely depressed or anxious for several reasons

1. I am still keeping myself and home clean
   

1. I am still eating properly
   

1. I am not abusing alcohol, recreational drugs etc
   

1. I am still interacting with people (albeit on a much more limited basis)
   

1. I am sleeping pretty well
   

But I feel so terrible inside, and the suicidal ideation is frightening and draining. I wake in the mornings filled with dread. I cry a lot, often for extended periods.

How bad do you have to be before your symptoms are considered severe? I assumed my symptoms must mean I was severe, but was getting by on strength of will alone.

But CPN says if I was severe then I'd lack strength of will.

Any thoughts?

[Graceymac]

The CPN is most probably referring to the lack of biological symptoms of clinical depression such as insomnia, poor appetite, consistent low mood for more than a two week period, diurnal mood variation, etc.

[memememe94]

Unfortunately, it seems resources are so stretched that MH services have to focus upon how dangerous a person is (to themselves or others) much more than how much someone is suffering. It's not fair or right, but it seems there's so little money to do much more than damage limitation. I've just been discharged from hospital after 5 weeks due to psychotic depression. I had lost touch with reality when admitted. The staff are lovely, but it's clear that their hugely stretchedpsych wards are just holding pens. The whole system is a mess. (I really respect MH staffmost I've met are good at their job--no criticism intended of them.)

[fieldofpurpleflowers]

parkykerry

[parkykerry]

I'm considered severely depressed by my mental health team. I'm unable to keep myself clean (don't wash for up to two weeks at a time) and my house is utterly awful (social services involvement level). Regularly self harm and a couple of suicide attempts already this year. DCs do suffer I'm ashamed to say, hence I do get a lot of professional recognition of the severity. I don't think I can imagine feeling as miserable and depressed as I do now, and managing to function to the outside world - being able to keep clean and meet basic daily tasks would mean to me that I'd achieved a certain level of wellbeing. But of course it varies for each person.

I just did the Goldberg test and I got 85, where 54+ indicates severe depression.

[barbecue]

If your Tradazone has only just gone up to 250mg it will be a while longer (2-4 weeks) before you feel the full effect of this dose.

[Room101isWhereIUsedToLive]

When I was at the height of my pnd and had a suicide plan, I still washed. I kept the house clean in a very uptight way.
I was spending every day in misery and despair. Luckily I was listened to and believed.
I got a referral for intensive psychotherapy through a university program.
So in my experience, it is possible to be very close to the edge and still functioning.
In your shoes, op, I would be approaching pals and saying that you are not being taken seriously and you need someone else in charge of your care.
It was PALS who got me on the road to the therapy.
I know how much of an ask it is, I had to do it when my gp had 'forgotten' to put me on the list for counselling.

[Psion]

Thank you for replying Wildrumpypumpus.

I think my GP won't change my meds either. I am still keeping myself and the house pretty clean and presentable. Still eating fairly well. I do have to force myself to act normal infront of DCs and find it a real effort to chat with them etc.

Did you find being admitted to hospital a positive thing ultimately?

[fieldofpurpleflowers]

I'm bipolar and have had episodes of severe clinical depression since I was 14. When it was severe, I developed psychotic symptoms and violently attempted suicide by crashing a car. I was hospitalised because I lost touch with reality.

Unfortunately you are at the mild-moderate end of depression in the context of mental healthcare.

The symptoms you describe still affect me even though I'm successfully medicated. There are days where I want to kill myself of self harm and I have to use CBT, routine, positive self-talk to get through.

I think a lot of people think that mild depression can be medically cured, but it usually can't. When you're out of the severe end, the stuff that makes the most difference if self-management - exercise, good diet, socialising, hobbies.

My meds pulled me out of "severe" but I know I'll manage mild-moderate forever and that's fine. Just manage your own expectations of what modern medicine can do at this point.

[Psion]

Thank you ReallyTired. I must admit that for a couple of hours in the very early morning after I wake, I feel so low and hopeless that I lie there virtually motionless.

But somehow I manage to finally drag myself into the shower and get dressed. Do a brief tidy up. Put some washing on. But have no real reserves left for much else. I struggle to even respond to text messages or emails and find it a real effort to carry on a conversation.

[TheWildRumpyPumpus]

My GP wouldn't have anything to do with my AD prescriptions as I was under the crisis team.

What extra do you want/need from the crisis team to help you feel better? I found it better to look at that aspect rather than focussing on how I was labelled.

At the point I was admitted to hospital I wasn't eating/washing/leaving the house/interacting with the children/had suicidal intentions.

Unfortunately the mental health services say that it's not unusual for people to have thoughts of suicide, and that in itself doesn't seem to be taken that seriously.

Hang in there.

[Psion]

Antihop, I had a review with the CT psych 5 days ago, when they increased my dosage for the third time in 9 weeks.

[unweavedrainbow]

What dose of quetiapine are you on? As you probably know, quetiapine is a mood stabiliser, not an anti-depressant, and so helps with impulsive behaviours and intrusive thoughts. It can be prescribed specifically to help with self-harm, so if you've started self-harming it might be worth discussing a dosage increase- the maximum quetiapine dosage is over 1000mg. As for the severity labels, remember that a CPN's job is really to keep you safe. If you can manage appropriate self care then you should be proud of yourself IMO, but lots of people can't and that's what she's comparing you to.

[Psion]

Barbecue, according to several websites 150mg - 300mg is the therapeutic dose of Quetiapine for anxiety/depression. So I'm not sure why the psych started me on just 25mg, and has very slowly titrated up to finally 150mg, 4 days ago.

Trazadone therapeutic dose is 100mg - 300mg, I think. Started on 100mg 9 weeks ago, and very slowly titrated up to 250mg 4 days ago.

[Psion]

Jamix, no I was relieved but I was just surprised as I assumed I would be considered severe as I felt so awful and desperate much of the time.

[ReallyTired]

I am sorry that you are ill. Depression is a wretched condition and sometimes labels like mild, moderate and severe do not help.

I don't think that the label of severe depression means how wretched you feel, its more how disabled you are by the condition. If someone is so depressed that they are catatonic (ie. motionless for extended periods.) then they have less in the way of mental reserves to pull themselves out of the depression.

[AntiHop]

Can you ask to see the crisis team doctor to review your medication?

[barbecue]

Ok, so if you're not on the full dosage yet it might be too early to say. When will you be up to the full amounts?

[Jaimx86]

So, as a follow on to my previous post (battery died), why do you want to be severely depressed? Aren't you relieved at your diagnosis?

[Psion]

It is the Crisis Team psych who has kept me on Trazadone + Quetiapine. Started me off onow doses and gradually titrating up.

[Tumtitum]

In my experience the GP might be reluctant to mess with your meds whilst you are being seen by a crisis team BUT could advocate for you if you are (understandably) finding this hard to do. Yes meds aren't all but are you being offered alternatives as well? Hope you feel better soon

[barbecue]

It's only a "very effective combination" of medication if it works for you. Different medications might work better for you and there are several you could try. Are there other professionals available for you to discuss this with? Could your GP or psychiatrist help?

[DickCheese]

Crisis team said I wasn't depressed either. I actually agree and think I have a different MH disorder. Could this be the case with you? It's hard because even though you might feel like you don't want to cook/clean/go to work you can't just stop doing everything so you're strong enough to keep functioning. It's awful isn't it, basically saying its normal to feel the way you're feeling but really you'd do anything to make it stop. Hope you get some help, try speaking with someone else. I self referred to a local 'wellbeing' place, not sure if it's a Charity or what but hopefully it's going to be a lot more helpful than GPs have been.

[Psion]

But won't that offend the Crisis Team, if I go behind them and see my GP? Would my GP prescribe in 'defiance' of what the CrisisTeam psychiatrist has had me on?