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 am probably mildly depressed, after feeling tired for so long, that's not a surprise"
Well that makes sense, and a physical condition can both make depression worse and vice versa. It does seem that maybe something else is going on too. Hope you get some answers. Have you told your GP you are stopping the mirtazapine? - it would be advisable that they know.

I haven't told her. I will. I may ask to go back to citalopram. Tho I feel I am taking them to please her. My appointment with the mental health team isn't til April so I have loads of time to take more notice of what I can do, when I am most tired, how I feel. Actually as I was writing this I realised a diary is a good idea.

Those results look like full blood count and a TSH. However, TSH is a pituitary hormone. I don't see anything there that tells us what is going on with your thyroid itself, nor do I see B12, D or ferritin. Looks to me like this G p has not done the right tests to make a proper diagnosis.

it's all a bit rubbish.

I did the BDI questionnaire. Got 11. Moderate depression. Just.

I seriously think I may go private. Your advice and encouragement has been great. Thank you all.

11 is really quite a low score, very mild. I've had patients who have scored way higher than that who are not on any medication. But antidepressants are sometimes prescribed for other conditions, including to treat medically unexplained symptoms; e.g. symptoms such as your tiredness for which no physical explanation has been found, are often thought to have a psychological element. Could it be that your GP is privately thinking there is a mind/body stress-related aspect to your illness and is prescribing on this basis without having properly explained this? In any case seeing the psychologist is a good idea, and if you can afford to see a consultant privately, then that would also be worthwhile.

A couple of instances in family and friends given diagnoses of depression has really made me suspicious of the diagnosis when it is against the patient's instincts.

The first was of someone who kept being diagnosed with depression against all her protests - turns out it was lymphoma (thankfully she recovered and I am not even suggesting that in your case OP).

The second turned out to be vanishingly low folic acid levels (discovered after we went to another GP who said he wanted to rule out all possible physical causes before looking at psychological ones).

I fear sometimes GPs turn to depression/anxiety type diagnoses before they have exhausted all physical possibilities.

I am much more alert. Which is great. I even went out last night with DH. Tho blimey, my thought process and coordination is gone. I am so clumsy it took me a lot longer to get ready than it should. Forgetful too. It really impacts on every day life

Grimble I think that my GP has decided depression and thats it.

Yes ghost, that's what I fear. Once some GPs have made up their minds they can be awfully difficult to persuade otherwise.

I got the confirmation of my psychology appt. There is a questionaire to fill out. One is CORE-10. I scored zero. I know I shouldn't, but I feel embarrassed now. I am totally wasting their time. Once I present that, I doubt very much they will want to spend much time with me.

I have no idea how to go private. Do I google, any recommendations? Any dos and don'ts. I have no choice but to go private now.

Have you heard of Hughes Syndrome? www.hughes-syndrome.org/about-hughes-syndrome/what-are-the-symptoms.php

What does zero mean? That you have no issues and are happy?
You should still go as it will prove to your doctor that it is not depression.
Don't forget the anti depressants you did take are probably still in your system so could be affecting your replies.
If anti depressants didn't cure your tiredness seems no good reason to take them!

Kerstina It means that I have no issues that would harm me and that I feel calm and not overwhelmed by anything, yes. Actually it's statements and statement 9 reads (in the past week) 'I have felt unhappy' I would tick 'not at all'. I am quite happy with life, I have told my gp this. I am still going to my appointment. It's important to officially rule depression out. I went to the gp because of tiredness and I am confused as to why she thinks tablets that make me even more tired are appropriate.

Thanks Local that's an interesting suggestion.

Depression can be the start of many illenesses including dementia can't elaborate though.

You should be offered a coeliac test purely on the basis of your thyroid issues, it's in the NICE guidelines for coeliac disease screening. I don't know much about going private but might be best to make your GP do these screening tests first to save money? Could be worth changing GP anyway.

She is doing a coeliac test. I will get the result in about another week. When I went back to push for more tests that was one she decided on. I have tried to Google going private but I haven't made sense of it yet. I will look at the NICE guidelines. Yy to changing GP.

My DF recently went private for a knee operation after NHS buggered him about for a year telling him he didn't need it etc. After meeting the consultant and getting the operation scheduled for a few weeks later turned out the operation was booked on the NHS. We never worked out exactly why (don't look a gift horse in the mouth) but figured the consultant recognised he should have had it done already if he'd been properly treated. So my take home message from that is to see an NHS consultant who also does private work as it'll be easier to get back into the normal system?

Coelic was negative. Vitamin D however was low. Below 20. I have to take a supplement and see how it goes. It was a different gp I spoke with. I did discover you can have glandular fever and not know. GP was busy telling me that I had it and I was "em...no!" Having had some time to think about it, it was probably 2 years ago when I would fall asleep at the dinner table and was generally fluey and very unwell. That lasted about 6 weeks, fatigue worse than usual continuing for longer. I was dismissed by a different gp then as well. This thread has been very helpful at keeping me focused. Bit cheesed off that I know have something else with symptoms of fatigue. I thought I would feel more upbeat that they found something but it just seems to be another addition to what has become a list. Maybe I will find my mojo once the supplements kick in.

Many endo sufferers report fatigue, it does appear to be one of the symptoms although some doctors won't accept it. I suspected that I had endometriosis about 12 years ago due to painful and heavy periods. A GP told me it was not possible as I had no pain in between periods. I raised it again about 7 years ago, and got the same reply. Recently I started experiencing problems with my bladder; an ultrasound discovered a large ovarian cyst, and now after an MRI I am told it's likely that I have severe endometriosis. Most GPs know very little about the condition. If you have frequent urination, get UTIs or have bad abdominal pain, you could try to get your GP to agree to an ultrasound scan - that was what changed things for me.

Also, various autoimmune diseases cause fatigue.

The only thing that works for me in getting over bouts of fatigue is to take it really easy - avoid stress, rest a lot, get outside each day if you can for a sort walk, don't try to exercise, just accept that for a while you need to rest.

Good luck