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!

I had no b12 recently. Dunno why. Both my husband and I thought I'd gone a bit nuts. I was tired. Bone tired. Lethargic. Little things were sending me into a temper or tears. Couldn't face doing house stuff. Things became 'hard' or a 'hassle'. I couldn't face much without feeling some sort of sad feeling in my tummy.

Finally saw the doctor. Had been 3 mths. Did blood tests inc b12 and diabetes. I had lost the b12. Literally a weekend of tablets and the change was remarkable. I was scared to say I was better incase I regressed a month later but it's been 3 and I haven't felt those feelings since.

Scary. Had no idea the effect one vitamin could have!

Slight digression-My DH's B12 got so low he had to have jabs in the GPs. < fnarrd fnarr> He morosely went off to the surgery and came back sparkly eyed, bouncy and chatting away like a 22 year old. It was absolutely astonishing!

SirV that's fantastic.

Last night my brother reminded me that my father had some sort of strange thing with his blood. He passed away a few years ago. Can the gp find out what it was? Dad never said what it was called. Something about not enough red blood cells. Mum doesn't remember what it was called either. Apparently my aunt may have something similar. We are a huge family and I don't really keep in touch with everyone.

Pernicious anaemia (aka vitamin B12 deficiency)?

Could you also be menopausal? I'm on HRT as well as levothyroxine and GF diet, taking vit D and had B12 injections, it all seems to go together...

I am a clinician in a mental health acces team - we are the first referral point for all mental Heath referrals; the majority from GP's. From what you have described, in my opinion you don't fit the criteria for a severe depression. We would be looking for symptoms like hopelessness and helplessness, potential thoughts of self harm, poor sleep pattern, poor appetite, no motivation to complete normal daily activities, lack of enjoyment in life etc. I would definitely suggest your GP investigates physical health causes for your symptoms.
If your GP does refer you for a psychiatric assessment and you do get assessed by a psychiatrist, they will ask for bloods to be done and if any physical issues are obvious, will ask your GP to follow these up. The psychiatrist will not necessarily diagnose physical health causes. In my experience, low iron levels can certainly contribute to a depressive illness.

Best of luck at getting to the route of your symptoms.

Low Folic acid?

RockinD I am not sure. I have looked into that today. I need to try to get straight answers from my mum I think.
I could be menopausal I guess. Its something else on my list.
summer111 your post gives me more confidence to be more assertive with the gp. Everyones posts have been really useful.

My gynae appt has been brought forward to tomorrow. Slight problem with my kidney function blood test, hopefully my op will go ahead.

Had my op. Well, the laparoscopy. Was gutted they couldn't do the endometrial ablation because my uterus is too small. So frustrating. Going to try the coil. Which I don't want to do too soon in case it messes with my existing symptoms.
Bum.

Went back to the gp. Total disaster. She is completely closed to the idea of anything else. I think she has been pissed off by one too many patients diagnosing themselves. Last time I was in I mentioned lymes disease. Was dismissed out of hand. This time, after me saying she hadn't really investigated other potential causes, decided to test for lymes, vit D, coeliac and HIV. By the time she listed HIV, I was fairly convinced she was pulling the piss. She doubted very much it was adrenal fatigue, never heard of saliva testing (my sw also mentioned to me that as a possibility because of my job). Wants me to continue on mirtazapine despite me saying I sleep longer and do less than I did before! I also am very irritable. I have decided to wean myself off.

Luckily my letter from psychology arrived yesterday too. I am going to go see them within the next 12 weeks. I am going for my blood tests on Monday so will ask the nurse for a print out of previous results, didn't dare ask the gp!!

Actually when I think of my appt yesterday, I just want to cry She told me several times to set my alarm clock. I told her if 3 kids and my husband don't wake me, I won't be getting up for an alarm clock.

Get your print out of your results and come back here with them. Make sure you get the reference ranges as well. Your results are your data and they cannot withhold them.

We'll get to the bottom of this for you.

Thanks RockinD. Should have been the gp saying that really. It was a most surreal experience. I find asserting myself very difficult, she just talked faster and louder than me. My favourite bit was when I was trying to say I feel happy with life, just pissed off that I am tired and don't achieve, I was told you can feel happy and be depressed. Happiness is just an emotion and the two should be mixed up.

I feel angry on your behalf! Everything you have described sounds just like how I feel and I know I don't have depression. I do however, have an underactive and almost certainly undermedicated thyroid. I am on the same dose as you and I just think it isn't enough. But also thryroid malfunction isn't as simple as "not enough thyroxine, fix with thyroxine". There can be something wrong in any part of the chain of events that gets T3 to your cells. You may test normal for T4, but your body may fail to convert that to T3, and you will still feel totally crap. Have you any money at all? Because I would have a private consult with someone expert in thyroid function. I'm thinking I may have to do that too, as thyroid knowledge in my GPs is patchy to say the least. I was accused of both depression and an alcohol abuse problem, due to thyroid misery and raised liver enzymes. I don't drink! GP clearly though I might be a closet wine guzzler....

SirVix I just said your name out loud get it now
Going private is an option. Definitely. Alcohol hasn't been mentioned to me. Probably because I get a yearly review for my work.
I know a lot of folk on thyroxine. Shocking gps can't/won't just refer to a specialist. Surely it makes more sense.

My best friend was sent to an endocrinologist by the GP. It had taken a while to diagnose what was wrong with her as she had slightly atypical symptoms and a stressful life, so maybe the GP felt she had been through enough. But I am still jealous as my GP hasn't ever suggested it.

I'm a psychiatrist and just wanted to reassure you that MOST of my fellow psychs will aim to rule out all physical causes before diagnosing depression. So just remain open minded, be honest in your appointment and say exactly how you're feeling and hopefully you will get to the bottom of it.

As an aside, Mirtaz can be quite sedating for some so could be making you worse!

Thanks guys. I absolutely am going to be honest. I have no fear of the diagnosis of depression. I just feel that, for me, it doesn't fit. My DH recently gave in after persuasion from me, went to the GP and was put on citalopram (sp) and hasn't looked back. Its been great for him. For both of us really.
I hope the person I see in psych fall under the category of most!

And if I do get a diagnosis of depression I will buy my GP a massive box of biscuits and apologise! !

I'm sorry you are going through this. I get extreme tiredness and lots of things you mention. Just don't have the energy to do small tasks. It turned out my folate, b12 and ferritin were low. I actually took a dip again last couple of weeks and I went to the gp and asked to be re-tested. She said she didn't think I needed it but agreed to do the blood tests anyway. Phone call from her last week to make an app as all three were low again!!!

You know your own body and what's 'normal' for you. Stick to your guns, you are doing great x

All seems fairly normal

Last one. I don't know what most of them are tbh.

I don't think this post worked first time.

OP, I am doubtful, as you are, that you meet the criteria for depression. I work in mental health. Has your GP used a diagnostic test? Given you a questionnaire to fill in? I am linking the two most commonly used ones. The first one is quicker and shorter.

phq-9
BDI

Majestic On the first one I scored 9. The GP filled one in with me previously but she decided the answers. I strongly felt that if she made things fit. I am probably mildly depressed, after feeling tired for so long, that's not a surprise. When she originally said depression I was ok with that based on these questions. When citilopram didn't buck me up (still very tired) she went with severe depression. She didn't listen when I said I felt better in myself. Put me on mirtazapine which wiped me out.

I actually got a dog so that I would be out and about walking. Just after I started citilopram. No probs. Up with the kids, out walking. 2 hours a day. Did nothing else tho. No energy to do more that the basic housework/dinners. I had hoped exercise and not going back to bed would kind of kick start me.Started colouring in to try to kick start my creative side (used to sell my craft work). Kids liked that, we did it together. All good. Except for being tired.When I was changed to mirtazapine, it all stopped. Dog walks got later. DHwas having to step up. I have weaned myself of. 2 days free now and that horrible tiredness is gone. Back to normal tired