"Wont prescribe ADs because youre on blood-thinners"

[Stormtreader]

Just been to my GP because I can feel depression coming in again - loss of appetite, waking up from a 10 hour sleep and wanting to call in sick so I can go back to sleep and hide.
Turns out the lovely new style blood-thinners Im on, that dont give me the horrible side effects that Warfarin/Rivoroxiban did, have major interactions with all the SSRI medication.

Hes going to check with the anti-coagulant people but it doesnt look good, we dont know when an answer will come because "The NHS is at breaking point".

All he could offer is if things get bad again, he can sign me off work again. I dont want to be signed off work, I want to just go back to being functional again! I credit Sertraline for lifting me out of it last time and now I cant have it. Im really scared for the future right now

Lamotrigine can sometimes be used to treat recurrent depression, but I'm not sure whether a GP could prescribe this. I take it for bipolar and it's a mood stabiliser (an anti-convulsant, not SSRI) that is especially effective when it comes to preventing depression. A psychiatrist prescribed it to me though. It's usually used for bipolar, but I've heard of people taking it for unipolar depression.

It might be unsuitable, but it could be worth suggesting it to your GP?

Meanwhile, just do what you can to try and minimise it. Eat as well as you can, try to maintain a good sleep pattern and get some regular exercise, assuming that you're well enough to manage this.

I hope this is just a blip and it rights itself quickly.

There are antidepressants other than SSRIs (SNRIs, TCAs and MAOIs), plus other classes of medications (atypical antipsychotics, anticonvulsants etc) which are sometimes used. So telling you that there is no medication at all to help you, and nothing else he can do, doesn't seem massively helpful. Did he not offer referral to talking therapy at least? Perhaps he did suggest other things to help, but the depression won't let you hear anything but the negative stuff. Stupid depression . If you are becoming more unwell, being signed off for a time so you can concentrate on getting better, might not be the worst thing anyway.

If you know medication has helped in the past, perhaps asking a pharmacist for advice on which medications used for depression do/don't have interactions with your other medication, and then taking that information to your GP, might be a start. It sounds like that's what he might be doing.

In the meantime I second all the basic stuff - eat healthily, drink enough water, try and get outside for a short walk in fresh air each day (or other exercise that suits you), try and maintain a good sleep pattern best you can. Have you been through CBT, used mindfulness etc before?

Get your vitamin d levels checked and supplement accordingly. Supplement with omega 3.

Good point Sofia. Ditto iron, B12 and thyroid function.

Thanks everyone, that's a good point about the blood tests and ill ask next time I'm in.

He did give me the leaflet to self-refer to the healthy minds service, but last time I tried them they offered me a group session that ran at 11am on a Wednesday - not so great when you have a full-time job. They also didn't contact me about any kind of solo counselling for 10 months, seems I got "lost". Luckily I managed to get the cash together for private counselling, I hate to think where I might have ended up without that.

The idea of being signed-off scares me because last time I had that I was spending 20+ hours per day asleep while waiting for the ADs to kick in, having to go to work forces some kind of structure on my day so I cant just hide in sleep.