my gp insists I have severe depression

[ghostinthecanvas]

and wants me to see a psychiatrist. I am a bit stunned and don't think she is correct. I had been willing to give her original diagnosis a shot and took the citalopram she prescribed. After a couple of months I went back to see her, told her nothing had changed. I was still tired, slept a lot, couldn't concentrate, get the bare minimum done. She changed antidepressants, diagnosed severe depression. Trouble is, I don't feel down, I enjoy things, look forward to seeing friends, have a laugh. Tho I prefer my own company, always have. Everything takes more of an effort than it used to. My brain isn't as sharp as it used to be, I am very slow at doing things. I really feel I am not depressed. Is it possible to be depressed and have absolutely no idea? I feel the gp has 20 years experience that I shouldn't dismiss. I am on thyroxine, level normal. I have had low iron, take daily supplement, level normal. I have endometriosis and am otherwise healthy. I have been tired for 4 years now, gradually getting worse. I would appreciate any advice. Apologies if I have written loads, hope you stuck with it!

Have you had full bloods done? My first thought was possibly a vit D deficiency...

Have you seen an endocrinologist regarding your thyroid?

Thyroid is screaming at me. Make sure you ask for a full panel of bloods. TSH should be 2 or less. Free T3, Free T4, Reverse T3, anti nuclear antibodies and anti thyroid antibodies. Vitamin D and C reactive protein to check for systemic inflammation. Ask for cortisol levels but make sure it's saliva not bloods. Insist on all of these to start.

Sounds like it could be mild Chronic Fatigue Syndrome. If you wake up unrefreshed even if you sleep a lot, that is a symptom of CFS. Also, have you checked your B12? It is not so easy to diagnose B12 deficiency, though the doctors aren't always willing to admit this. You could try taking zinc, B12, vitamin C and D, in addition to the iron, and see if that helps.

We have had a huge problem with CFS, and have found that MANY doctors are utterly useless when it comes to dealing with this complicated and debilitating illness. I hope this is not what you have, but if you suspect it might be, there are some helpful threads if you search chronic fatigue. Good luck-

Has she suggested a sleep study?

I second cfs/me I've had it 4 or 5 years now and it's terrible.

the tiredness and fogginess could be a dairy or gluten thing.

id try and reduce the anti ds and try cuttimg dairy and gluten out of your diet for a couple of weeks.

My autonomic system is messed up, it's often misdiagnosed as CFS, it makes you tired and gives brain fog.

I have depression at times and at one point I knew I wasn't depressed but felt awful and tired and various doctors tried to tell me I was depressed.
As pp suggested it was a gluten problem. I had the beggings of IBD which is inflamed by gluten and I felt hungover for 2 years.
I excluded gluten on medical advice and 7 days later was fine!

I think you're right. You certainly don't sound like you have severe depression, or even mild depression. I think sometimes GP fall back on this diagnosis when they can't find any other reason for your symptoms.

CFS is difficult to diagnose and can usually only be done by a process of elimination. But being tired for 4 years isn't right as I'm sure you know. Maybe see her again and ask about the possibility of CFS or ME as it's sometimes called. I have heard people say that they were diagnosed with depression when they actually had CFS.

Have a look at this. It'll give you an idea if you could meet the criteria
I find it interesting ATM how many introverted people are told they are depressed

I had this problem, a few different GPs insisting I was depressed. I knew I wasn't as, like you, I also looked forward to things and enjoyed life. I also had poor concentration, brain fog, joint pain, tiredness, & heavy periods. All blood results were normal.

One day I read a thread on MN where a poster was suggesting that someone should remove gluten from their diet to help with joint pain. I decided I had nothing to lose by trying and 6 months on all of my symptoms have gone (I started to notice a difference after the first week!)

It's a bit of a pain having to check all food labels but worth it to feel better. I would recommend anyone with heavy periods or cfs to consider going gluten free for while & see if it makes a difference.

I feel the same as you at the moment and I also have an underactive thyroid. I would be interested to know what your levels are? I am off to the GP this week to get mine tested again as I think I need more thyroxine (my daily dose is pretty low at the moment). But the other suggestions are interesting. There is a link between thyroid disease and coeliac disease, have you been tested for that? (I am almost certainly coeliac but I don't eat gluten so in my case that isn't causing my flatness and exhaustion.)

Thank you all very much. I am going to go back. I will write down a lot of what is on here and ask for a complete check. I think what made me react most was the idea of seeing a psychiatrist. I just knew they would be having their time wasted and its a precious enough resource. I am going to reread the thread tomorrow when I feel sharper. The antidepressant I have been given helps sleep so for that alone I think I may try it. My family and friends don't think I am depressed. My job is very stressful. I foster and it is very full on. That in itself will affect me. When I started to talk about my job I started with the sentence "I am a foster..." and got "yes, I remember". I tried to ask about endometriosis (causes fatigue), got shut down. Because my brain fog is really bad, I forget what I want to say. Its affected my confidence when having conversation. Thanks again for the responses and ssuggestions.

Gluten free is going to be something I can try right now. Going to try it. Thanks.

I am glad your going back to the GP. What surprised me was a friend had a breakdown and told me a psychiatrist will rule out medical conditions.

Really? That's interesting. I feel really strongly that my gp has a check list! She put me on thyroxine when my previous gp wouldn't. He said borderline was fine! I have asked for my bloods to be retested but present gp says not necessary, last test was only 5 months ago. Been on thyroxine about 8 months. I still love that I am no longer cold. GP has never suggested any other alternatives. I wonder if she is passing the buck a bit?

Don't forget it takes quite a while for thyroxine to fully take effect, no matter what the blood tests say. For example, it took about two years for me to feel back up to thyroid speed after I was up to the correct dose.

Thanks tobee I never realised it would take that long.
I have read all the replies properly. My plan now is:
Back to gp. Ask for full bloods and the cortisol test. I will write down the list on here. Make sure she does them, then I will get a print out.

Later today I will go get gluten free bread and pasta. Try that for a couple of weeks.
I took my mirtazapine 15g for the first time last night, had the worst nights sleep I've had for a while. I had what I think was restless legs. Bloody horrible. I will see. I will decamp to the spare room for 3/4 nights a week as I sleep better alone.
Is it a problem going glutenfree right now, the same time as new tablets? How do I know which works? Go back on gluten after 2 weeks? If I haven't binned the antidepressants before then?
The sleep doctor suggestion I will keep for if the spare room doesn't work.
Thanks again for all the suggestions.

RonaldMcdonald I read your download thank you. I got 4, not 5. I function fairly well so, going by that, I seem to be affected by tiredness.

See a different GP and get a second opinion.

Sometimes GPs do try to speak to patients about depression to see if that might be what they are experiencing or to let the patient get involved in a dialogue about it - often people find it hard to put words to or admit

Sometimes it seems clear that a person fulfils the diagnostic criteria for depression but the symptoms for other things should always be checked out first..as a group of symptoms might add together to seem like depression but could be part of an illness and part of the response to the illness
A psychiatrist can ensure that the tests necessary for many common illnesses take place if this has not been carried out by the GP but I'd insist that the GP do it

Tell him you've looked at the diagnostic criteria for depression and don't believe that you meet the criteria...open the dialogue and ask what happens next

Hope you feel better soon

can you not go with the flow and see a psychiatrist? they are not bad people

HoraceCope I am kind of tempted to do that. Especially now I know they investigate everything else. That would also cover seeing another gp. I feel I always go with the flow as its less hassle. I don't want to make someone who really needs an appt with a psychiatrist to wait longer because of me.

You have an underactive thyroid and low iron levels, but your doc thinks you have severed depression? Oh Lordy, what is the world coming to? I'm no doctor, but isn't this crying out for a full thyroid review to make sure you are optimally medicated and including vitamin B12, folate, vitamin D,ferritin and a full iron panel?

Having said that though, it might be worth seeing the psychiatrist, just the once. I got pushed down this route some years ago and it was quite useful to be pronounced mentally sound - stopped the doc in his tracks! Also psychiatrists usually know about the influence of under treated thyroid conditions on mood and motivation.

It would be useful to get into the habit of getting a copy of your test results with the reference ranges, so you can see where you stand. It's surprising how often doing that throws up results that have been flagged by the lab and ignored by the GP!