Major depressive disorder

[ChelseaWatson]

I’ve been recently diagnosed with major depressive disorder and the psychiatrist has advised my gp to increase my AD. I’ve been depressed on and off for around 20 years and just ploughed on and thought it was just life. But circumstances before Christmas and in the last year have made my resilience far less effective and I can’t hide it anymore. Thing is, despite the psychiatrist telling me I am very unwell and need to take it seriously, I don’t feel like it’s real as I feel there are people far worse off than me. Not sure why I’m posting but I feel alone and stuck.

I am currently recovering from a moderate depressive episode (I have bipolar). I didn’t even realise I was depressed as I kept functioning but my brain definitely cognitively narrowed and tasks were so hard. My feelings had numbed so I didn’t feel sad or down. I also got a building pressure in my chest, which is what made me realise I had to call out. I didn’t know depression could feel that way.

So much of it is hidden inside that it can feel like it’s not really happening, as the decline happens so slowly you don’t realise how ill you’ve become. Most people never realise how ill you are but it sounds as though your psychiatrist has.

What specifically do they feel you need to take seriously? Medication, rest?

It’s strong people who get into an untenable situation and just keep going. I had my first recognisable (to me) depressive period in my early 20s. Never had any medication help over the years, despite going to the doctors periodically, Tried every private therapy going. Lockdown finished my descent off the metaphorical cliff and I was hospitalised and sectioned in my early 50s with an episode of hypomania. I realised that when I had been worried I was overcomplaining I was actually under complaining .

It’s a really tough position to be in. I’m glad you’re getting the professional help you need from a psychiatrist and I hope you feel a bit better very soon.

@ChelseaWatson Please don’t think you are alone - depression is very isolating illness so it’s common to feel that way.
it’s good you are getting help and there’s a lot to be hopeful for.
im in a bad way myself so I can empathise, am waiting on psychiatrist appt Monday and it feels like a million miles away 😖
try the increased dose and if that’s no good then I’m sure there’s lots of other options. Being on the right meds is life changing xx

Thanks for replying. I’m not really having a good few days to be honest. I feel guilty for not being at work although work has caused the latest decline in my MH. I feel guilty for not being a better mum/wife. There is also a trauma associated in my MH difficulties and I don’t know how I’m going to get out of this rut. If it wasn’t for the kids seriously.

Have you started the increase of ADs? Have you told your GP or psychiatrist how you are feeling. It’s so difficult when all the symptoms are on the inside and you are nominally coping on the outside.

How did your appointment go?

Starting increased dose tomorrow

Great that can get started. All the best with it helping. Have you been given a date by wihich you tell them whether things have improved. If that hasn’t been discussed, then I’d set a reminder for 1 week and 2 weeks and let them know if you’re not significantly better. You’re 5 mins in their day and this is your life so hard as it when you’re so low, it’s important you keep flagging.

Are you able to rest?

I’m signed off work until next week and want to return on a phased return but not sure I should. Seeing consultant again in 6 weeks

What are the consequences at your work if you ask the GP if you can stay off until your next appointment with consultant?

It’s a personal balance: I have to keep busy and not linger in bed but I can’t take much pressure at all and have had to give up work.

Not sure of the consequences really. Work has been a massive factor in recent issues which they know about. Line manager wants to meet me at the end of the month.

Is it easier to stay off and definitely be ready to return (rather than risk starting back and having to go off again?).

I’m still waiting, it’s on Monday. I am looking at asking to try either escitalopram or (sp?) aglomelantine. I think the aglo one might be good for me as it affects melatonin and is meant to be good for sleep which is always the challenge I seem to have with antidepressants, I get jittery and insomnia 😖 mirtazipine and trazodone have been good for sleep but no effect on depression which is a shame

In the subject of work and time off what about trying to do a very gradual phased on reduced hours? Depends on their policy I suppose tho as they are not (I believe) obligated to pay you for your normal hours if you are reduced. Mine did pay me full time which was nice of them as I have just had over two months phased return
NHS have the best sickness, unless it’s changed then you get 6 months on full pay. My husband is in fire service and if it is work related stress you get 12 months!

I don’t know if it’s the same for unipolar depression but bipolar is increasingly understood to be linked to circadian rhythm. I am on lithium. My old consultant gave sedative options for sleep issues when they got so bad periodically but just seen a new consultant and he read though all my notes and determined that sleep issues predated the depression and gave me melatonin instead. It isn’t known for being that great for non-depression related insomnia but it’s been magic for me. I get to sleep now and if I wake up I can get back to sleep. My overeating has stopped too.

All the best for Monday.

@WinterFelinePurring thanks x
yes my diagnosis is bipolar type 2. I have a nightmare with antidepressants so I am worried about trying another one but I really think I need it, I’m emotionally unstable 😖

Definitely have a chat about trying melatonin then if you haven’t tried it before. I woke this morning and didn’t dread the day for the first time in 2.5 years. My consultant described my depression as moderate 3 weeks ago - it’s not gone but it is much milder now.

Well I’m back from the appointment. Went well I think. I am going to try escitalopram and they have changed my quetiapine from extended release to immediate release. I really hope it helps 😖
now I’m having work related dilemma as I’m meant to be on 8 till 5 tomorrow and I think it will be too much (have to leave at 7.20 and get back half 5 so it’s along day) the psychiatrist suggested I shouldn’t be at work maybe but I need the routine and normality I think - but 9 hrs of it is too much as it’s working with patients and I see about 25 on average and some of them are not always very pleasant so I’m going to bite the bullet and ask to start at 10 and finish at 3 for next 2 weeks while I adjust. It’s either that or go off sick which I don’t want to do as I can’t be sat twiddling my thumbs doing into depressive rabbit hole 😖